Open AccessBochdaleck’s hernia complicating pregnancy: Case report
Author(s) -
Nikolaos Barbetakis,
Andreas Efstathiou,
Michalis Vassiliadis,
Theocharis Xenikakis,
Ioannis Fessatidis
Publication year - 2006
Publication title -
world journal of gastroenterology
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v12.i15.2469
Subject(s) - medicine , surgery , pregnancy , diaphragmatic hernia , bowel resection , hernia , gangrene , gestation , atelectasis , anastomosis , diaphragmatic breathing , bowel obstruction , congenital diaphragmatic hernia , fetus , lung , genetics , alternative medicine , pathology , biology
Diaphragmatic hernia complicating pregnancy is rare and results in a high mortality rate, particularly if early surgical intervention is not undertaken. We report a case in which a woman presenting at 23 wk's gestation was admitted with symptoms of respiratory failure and bowel obstruction due to incarceration of viscera through a left posterolateral defect of the diaphragm (Bochdalek's hernia). Surgery (left thoracoabdominal incision) demonstrated compression atelectasis, mediastinal shift, strangulation and gangrene of the herniated viscera which led to segmental resection of the involved portion of large intestine with re-establishment of bowel continuity by end to end anastomosis. The greater omentum was partly necrotic necessitating resection. The diaphragmatic defect was closed with interrupted sutures. Postoperative period was uncomplicated. Pregnancy was allowed to continue until 39 wk's gestation at which time elective cesarean delivery was performed. It is concluded that symptomatic maternal diaphragmatic hernia during pregnancy is a surgical emergency and requires a high index of suspicion.