Bochdalek hernia in an adult with Down's syndrome

Abstract

Bochdalek hernia in very rare in adults. We recently treated an adult with Bochdalek hernia. The patient was a 41-year-old male with Down's syndrome. Chromosome analysis showed a genotype of 47XY +21, indicating Down's syndrome. Chest X-ray films showed a mass in the left supradiaphragmatic region, but the patient was asymptomatic. The spleen was seen in both the thoracic and abdominal cavities in CT scans. We diagnosed Bochdalek hernia and performed a left thoracotomy. The area of the defect in the diaphragm was 70 cm², and the hernia sac containing the spleen protruded into the thoracic cavity from the abdominal cavity. It was easy to replace the spleen into the abdominal cavity, but we were unable to suture the defect of the diaphragm directly. Finally, we closed the defect with a Gortex soft tissue patch. This is the first report of a case of Bochdalek hernia in a patient with Down's syndrome.