Abstract
Most cases of foramen of Bochdalek hernia become severely symptomatic in the neonatal period when intraperitoneal organs prolapse into the chest cavity. However, in rare cases, patients remain asymptomatic for years and the condition is diagnosed after they reach adulthood. We treated an adult case of foramen of Bochdalek hernia and achieved total repair with thoracoscopic surgery alone. The patient was a 38-year-old woman who had delivered twins at the age of 27. She complained of discomfort and pain in the left chest of a few day's duration and was examined at our hospital in September 2012. Based on plain chest radiographs and computed tomography of the chest, a diagnosis of left diaphragmatic hernia was made. In November, the patient underwent totally thoracoscopic surgery with differential lung ventilation in the right half-lateral decubitus position. At this time, thoracoscopy revealed adult Bochdalek hernia. The hernia orifice was closed with 2-0 absorbable interrupted sutures and reinforced with Gore-Tex Dual Mesh®. The patient was discharged on the 8th hospital day, and has remained well with no recurrence for 2.5 years since surgery.
