PDF(Pubmed)
Abstract：
BACKGROUND: A Bochdalek hernia (BH) is a congenital diaphragmatic hernia that often develops in the neonatal period. BH typically occurs on the left side of the diaphragm. A right-sided BH in an adult is rare.
METHODS: A 45-year-old man was referred to our hospital because of an abnormal shadow seen on chest radiography during a medical check-up. A chest radiograph showed elevation of the right hemidiaphragm. Computed tomography showed prolapse of multiple intraabdominal organs into the right thoracic cavity, corresponding to a right-sided BH. The herniated contents included the stomach, transverse colon, and left lobe of the liver. The left lobe of the liver was enlarged, particularly the medial segment. Laparoscopic surgery was performed. However, the left lobe of the liver was completely trapped in the thoracic cavity. Therefore, thoracoscopic manipulation had to be performed to return the liver to the abdominal cavity. The hernia was repaired with interrupted nonabsorbable sutures and reinforced with mesh.
CONCLUSIONS: Combined laparoscopic and thoracoscopic surgery was successfully performed for right-sided BH with massive liver prolapse and abnormal liver morphology.
METHODS: A 45-year-old man was referred to our hospital because of an abnormal shadow seen on chest radiography during a medical check-up. A chest radiograph showed elevation of the right hemidiaphragm. Computed tomography showed prolapse of multiple intraabdominal organs into the right thoracic cavity, corresponding to a right-sided BH. The herniated contents included the stomach, transverse colon, and left lobe of the liver. The left lobe of the liver was enlarged, particularly the medial segment. Laparoscopic surgery was performed. However, the left lobe of the liver was completely trapped in the thoracic cavity. Therefore, thoracoscopic manipulation had to be performed to return the liver to the abdominal cavity. The hernia was repaired with interrupted nonabsorbable sutures and reinforced with mesh.
CONCLUSIONS: Combined laparoscopic and thoracoscopic surgery was successfully performed for right-sided BH with massive liver prolapse and abnormal liver morphology.
摘要：
背景：Bochdalek疝（BH）是一种先天性膈疝，通常在新生儿期发展。BH通常发生在隔膜的左侧。成人的右侧BH很少见。
方法：一名45岁的男子因体检时胸部X线照片上的异常阴影而被转诊到我们医院。胸部X光片显示右半膈抬高。计算机断层扫描显示多个腹内器官脱垂到右胸腔，对应于右侧BH。突出的内容物包括胃，横结肠,还有肝脏的左叶.肝脏左叶肿大,特别是中间段。进行腹腔镜手术。然而,肝脏的左叶完全被困在胸腔中。因此,必须进行胸腔镜操作才能将肝脏返回腹腔。疝用间断的不可吸收缝线修复，并用网片加固。
结论：腹腔镜和胸腔镜联合手术成功治疗右侧BH并肝大量脱垂和肝脏形态异常。
方法：一名45岁的男子因体检时胸部X线照片上的异常阴影而被转诊到我们医院。胸部X光片显示右半膈抬高。计算机断层扫描显示多个腹内器官脱垂到右胸腔，对应于右侧BH。突出的内容物包括胃，横结肠,还有肝脏的左叶.肝脏左叶肿大,特别是中间段。进行腹腔镜手术。然而,肝脏的左叶完全被困在胸腔中。因此,必须进行胸腔镜操作才能将肝脏返回腹腔。疝用间断的不可吸收缝线修复，并用网片加固。
结论：腹腔镜和胸腔镜联合手术成功治疗右侧BH并肝大量脱垂和肝脏形态异常。
