A case of right-sided Bochdalek hernia incidentally diagnosed in a gastric cancer patient

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: Bochdalek hernia (BH) is generally congenital, presenting with respiratory distress. However, this pathology is rarely detected in adults. Some adult cases of BH present with symptoms attributed to the hernia, but incidental detection of BH is increasing among asymptomatic adults due to advances in imaging modalities. This report presents the management of incidental BH patients detected in the preoperative period of gastric cancer. Case presentation: An asymptomatic 76-year-old woman was diagnosed with advanced gastric cancer during follow-up after radiotherapy for uterine cervical cancer. Computed tomography (CT) was performed to exclude metastatic gastric cancer, incidentally detecting right-sided BH. We planned distal gastrectomy with lymph node dissection for gastric cancer and simultaneous repair of BH using a laparoscopic approach. We performed laparoscopic gastrectomy for gastric cancer and investigated the right-sided BH to assess whether repair during surgery was warranted. Herniation of the liver into the right hemithorax was observed, but was followed-up without surgical repair because the right hepatic lobe was adherent to the remnant right anterior hemidiaphragm and covered the huge defect in the right hemidiaphragm. No intra- or postoperative pneumothorax was observed during pneumoperitoneum. Conclusion: Regardless of symptoms, repair of adult BH is generally recommended to prevent visceral incarceration. However, BH in asymptomatic adults appears to be more common than previously reported in the literature. Surgeons need to consider the management of incidental BH encountered during thoracic or abdominal surgery.

Original languageEnglish
Article number34
JournalBMC Surgery
Volume16
Issue number1
DOIs
Publication statusPublished - 2016

Fingerprint

Stomach Neoplasms
Gastrectomy
Congenital Diaphragmatic Hernias
Preoperative Period
Pneumoperitoneum
Liver
Pneumothorax
Hernia
Lymph Node Excision
Uterine Cervical Neoplasms
Radiotherapy
Thorax
Tomography
Pathology

Keywords

  • Adult
  • Bochdalek hernia
  • Congenital diaphragmatic hernia
  • Laparoscopic surgery
  • Right-sided

ASJC Scopus subject areas

  • Surgery

Cite this

@article{6f3830dcfe124ada80d8e321f4bd1fd3,
title = "A case of right-sided Bochdalek hernia incidentally diagnosed in a gastric cancer patient",
abstract = "Background: Bochdalek hernia (BH) is generally congenital, presenting with respiratory distress. However, this pathology is rarely detected in adults. Some adult cases of BH present with symptoms attributed to the hernia, but incidental detection of BH is increasing among asymptomatic adults due to advances in imaging modalities. This report presents the management of incidental BH patients detected in the preoperative period of gastric cancer. Case presentation: An asymptomatic 76-year-old woman was diagnosed with advanced gastric cancer during follow-up after radiotherapy for uterine cervical cancer. Computed tomography (CT) was performed to exclude metastatic gastric cancer, incidentally detecting right-sided BH. We planned distal gastrectomy with lymph node dissection for gastric cancer and simultaneous repair of BH using a laparoscopic approach. We performed laparoscopic gastrectomy for gastric cancer and investigated the right-sided BH to assess whether repair during surgery was warranted. Herniation of the liver into the right hemithorax was observed, but was followed-up without surgical repair because the right hepatic lobe was adherent to the remnant right anterior hemidiaphragm and covered the huge defect in the right hemidiaphragm. No intra- or postoperative pneumothorax was observed during pneumoperitoneum. Conclusion: Regardless of symptoms, repair of adult BH is generally recommended to prevent visceral incarceration. However, BH in asymptomatic adults appears to be more common than previously reported in the literature. Surgeons need to consider the management of incidental BH encountered during thoracic or abdominal surgery.",
keywords = "Adult, Bochdalek hernia, Congenital diaphragmatic hernia, Laparoscopic surgery, Right-sided",
author = "Satoru Kikuchi and Masahiko Nishizaki and Shinji Kuroda and Shunsuke Kagawa and Toshiyoshi Fujiwara",
year = "2016",
doi = "10.1186/s12893-016-0145-2",
language = "English",
volume = "16",
journal = "BMC Surgery",
issn = "1471-2482",
publisher = "BioMed Central",
number = "1",

}

TY - JOUR

T1 - A case of right-sided Bochdalek hernia incidentally diagnosed in a gastric cancer patient

AU - Kikuchi, Satoru

AU - Nishizaki, Masahiko

AU - Kuroda, Shinji

AU - Kagawa, Shunsuke

AU - Fujiwara, Toshiyoshi

PY - 2016

Y1 - 2016

N2 - Background: Bochdalek hernia (BH) is generally congenital, presenting with respiratory distress. However, this pathology is rarely detected in adults. Some adult cases of BH present with symptoms attributed to the hernia, but incidental detection of BH is increasing among asymptomatic adults due to advances in imaging modalities. This report presents the management of incidental BH patients detected in the preoperative period of gastric cancer. Case presentation: An asymptomatic 76-year-old woman was diagnosed with advanced gastric cancer during follow-up after radiotherapy for uterine cervical cancer. Computed tomography (CT) was performed to exclude metastatic gastric cancer, incidentally detecting right-sided BH. We planned distal gastrectomy with lymph node dissection for gastric cancer and simultaneous repair of BH using a laparoscopic approach. We performed laparoscopic gastrectomy for gastric cancer and investigated the right-sided BH to assess whether repair during surgery was warranted. Herniation of the liver into the right hemithorax was observed, but was followed-up without surgical repair because the right hepatic lobe was adherent to the remnant right anterior hemidiaphragm and covered the huge defect in the right hemidiaphragm. No intra- or postoperative pneumothorax was observed during pneumoperitoneum. Conclusion: Regardless of symptoms, repair of adult BH is generally recommended to prevent visceral incarceration. However, BH in asymptomatic adults appears to be more common than previously reported in the literature. Surgeons need to consider the management of incidental BH encountered during thoracic or abdominal surgery.

AB - Background: Bochdalek hernia (BH) is generally congenital, presenting with respiratory distress. However, this pathology is rarely detected in adults. Some adult cases of BH present with symptoms attributed to the hernia, but incidental detection of BH is increasing among asymptomatic adults due to advances in imaging modalities. This report presents the management of incidental BH patients detected in the preoperative period of gastric cancer. Case presentation: An asymptomatic 76-year-old woman was diagnosed with advanced gastric cancer during follow-up after radiotherapy for uterine cervical cancer. Computed tomography (CT) was performed to exclude metastatic gastric cancer, incidentally detecting right-sided BH. We planned distal gastrectomy with lymph node dissection for gastric cancer and simultaneous repair of BH using a laparoscopic approach. We performed laparoscopic gastrectomy for gastric cancer and investigated the right-sided BH to assess whether repair during surgery was warranted. Herniation of the liver into the right hemithorax was observed, but was followed-up without surgical repair because the right hepatic lobe was adherent to the remnant right anterior hemidiaphragm and covered the huge defect in the right hemidiaphragm. No intra- or postoperative pneumothorax was observed during pneumoperitoneum. Conclusion: Regardless of symptoms, repair of adult BH is generally recommended to prevent visceral incarceration. However, BH in asymptomatic adults appears to be more common than previously reported in the literature. Surgeons need to consider the management of incidental BH encountered during thoracic or abdominal surgery.

KW - Adult

KW - Bochdalek hernia

KW - Congenital diaphragmatic hernia

KW - Laparoscopic surgery

KW - Right-sided

UR - http://www.scopus.com/inward/record.url?scp=85009799184&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85009799184&partnerID=8YFLogxK

U2 - 10.1186/s12893-016-0145-2

DO - 10.1186/s12893-016-0145-2

M3 - Article

C2 - 27245581

AN - SCOPUS:85009799184

VL - 16

JO - BMC Surgery

JF - BMC Surgery

SN - 1471-2482

IS - 1

M1 - 34

ER -