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A Rare Case of Bochdalek Hernia with Concomitant Para-Esophageal Hernia, Repaired Laparoscopically in an Octogenarian

Patient: Male, 81 Final Diagnosis: Bochdalex hernia Symptoms: Chest pain • vomiting Medication: — Clinical Procedure: Laparoscopic repair of both diaphragmatic hernias Specialty: Surgery OBJECTIVE: Rare co-existance of disease or pathology BACKGROUND: A Bochdalek hernia (BH) is a rare congenital con...

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Autores principales: Susmallian, Sergio, Raziel, Asnat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5716375/
https://www.ncbi.nlm.nih.gov/pubmed/29184050
http://dx.doi.org/10.12659/AJCR.906225
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author Susmallian, Sergio
Raziel, Asnat
author_facet Susmallian, Sergio
Raziel, Asnat
author_sort Susmallian, Sergio
collection PubMed
description Patient: Male, 81 Final Diagnosis: Bochdalex hernia Symptoms: Chest pain • vomiting Medication: — Clinical Procedure: Laparoscopic repair of both diaphragmatic hernias Specialty: Surgery OBJECTIVE: Rare co-existance of disease or pathology BACKGROUND: A Bochdalek hernia (BH) is a rare congenital condition consisting of a posterolateral defect in the diaphragm. A para-esophageal hernia (PEH) is a rare variant of hiatus hernia. BH and PEH may present with gastric volvulus or incarceration, requiring emergency treatment. Minimally invasive surgery is the preferred treatment, particularly for elderly patients and patients with comorbidities. The occurrence of BH with concomitant PEH is a very rare event. We describe a case of an octogenarian patient with BH and concomitant PEH treated laparoscopically. CASE REPORT: An 81-year-old male patient, without significant comorbidities, presented with a two-month history of severe chest pain and vomiting after eating. Cardiological investigations ruled out cardiac ischemia, infarction, or other cardiovascular abnormalities. Chest and abdominal computed tomography (CT) imaging demonstrated a large diaphragmatic hernia, with the entire stomach in the left thorax. Laboratory results showed mild anemia and a low iron level. The patient underwent simultaneous laparoscopic repair of a BH and a PEH with mesh reinforcement without antireflux fundoplication. The patient’s postoperative recovery was uneventful. CONCLUSIONS: We have presented a rare case of BH with concomitant PEH in an octogenarian that was successfully treated with laparoscopic surgery. Although these two forms of hernia are a very rare association, this case report illustrates that the surgical approach should be individualized in each patient’s case to ensure a successful surgical outcome. In this case, the decision was made to suture the diaphragmatic crura and reinforce the diaphragm repair with mesh, rather than by fundoplication.
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spelling pubmed-57163752017-12-07 A Rare Case of Bochdalek Hernia with Concomitant Para-Esophageal Hernia, Repaired Laparoscopically in an Octogenarian Susmallian, Sergio Raziel, Asnat Am J Case Rep Articles Patient: Male, 81 Final Diagnosis: Bochdalex hernia Symptoms: Chest pain • vomiting Medication: — Clinical Procedure: Laparoscopic repair of both diaphragmatic hernias Specialty: Surgery OBJECTIVE: Rare co-existance of disease or pathology BACKGROUND: A Bochdalek hernia (BH) is a rare congenital condition consisting of a posterolateral defect in the diaphragm. A para-esophageal hernia (PEH) is a rare variant of hiatus hernia. BH and PEH may present with gastric volvulus or incarceration, requiring emergency treatment. Minimally invasive surgery is the preferred treatment, particularly for elderly patients and patients with comorbidities. The occurrence of BH with concomitant PEH is a very rare event. We describe a case of an octogenarian patient with BH and concomitant PEH treated laparoscopically. CASE REPORT: An 81-year-old male patient, without significant comorbidities, presented with a two-month history of severe chest pain and vomiting after eating. Cardiological investigations ruled out cardiac ischemia, infarction, or other cardiovascular abnormalities. Chest and abdominal computed tomography (CT) imaging demonstrated a large diaphragmatic hernia, with the entire stomach in the left thorax. Laboratory results showed mild anemia and a low iron level. The patient underwent simultaneous laparoscopic repair of a BH and a PEH with mesh reinforcement without antireflux fundoplication. The patient’s postoperative recovery was uneventful. CONCLUSIONS: We have presented a rare case of BH with concomitant PEH in an octogenarian that was successfully treated with laparoscopic surgery. Although these two forms of hernia are a very rare association, this case report illustrates that the surgical approach should be individualized in each patient’s case to ensure a successful surgical outcome. In this case, the decision was made to suture the diaphragmatic crura and reinforce the diaphragm repair with mesh, rather than by fundoplication. International Scientific Literature, Inc. 2017-11-29 /pmc/articles/PMC5716375/ /pubmed/29184050 http://dx.doi.org/10.12659/AJCR.906225 Text en © Am J Case Rep, 2017 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Articles
Susmallian, Sergio
Raziel, Asnat
A Rare Case of Bochdalek Hernia with Concomitant Para-Esophageal Hernia, Repaired Laparoscopically in an Octogenarian
title A Rare Case of Bochdalek Hernia with Concomitant Para-Esophageal Hernia, Repaired Laparoscopically in an Octogenarian
title_full A Rare Case of Bochdalek Hernia with Concomitant Para-Esophageal Hernia, Repaired Laparoscopically in an Octogenarian
title_fullStr A Rare Case of Bochdalek Hernia with Concomitant Para-Esophageal Hernia, Repaired Laparoscopically in an Octogenarian
title_full_unstemmed A Rare Case of Bochdalek Hernia with Concomitant Para-Esophageal Hernia, Repaired Laparoscopically in an Octogenarian
title_short A Rare Case of Bochdalek Hernia with Concomitant Para-Esophageal Hernia, Repaired Laparoscopically in an Octogenarian
title_sort rare case of bochdalek hernia with concomitant para-esophageal hernia, repaired laparoscopically in an octogenarian
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5716375/
https://www.ncbi.nlm.nih.gov/pubmed/29184050
http://dx.doi.org/10.12659/AJCR.906225
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