A Case of Bochdalek Hernia Coexisting with Pancreatitis During Pregnancy

Abstract

Diaphragmatic hernia complicating pregnancy is rare and its coexistence with pancreatitis is even less common. Herein, we report the case of a 22-year-old primigravid female who presented with pancreatitis complicating Bochdalek hernia. The patient was transferred to our hospital from a neighborhood clinic at 32 weeks of gestation with the symptoms of nausea and abdominal pain and high serum amylase levels. Laboratory examinations and abdominal computed tomography revealed left diaphragmatic hernia and mild acute pancreatitis. We selected conservative management, For her 32 weeks of gestation and her overall condition was stable as the maternal and fetal conditions, as well as the overall general condition of the patient, were stable at 32 weeks of gestation and we expected fetal lung maturation. On day 2 of admission, she developed dyspnea. A plain chest X ray showed mediastinal shift to the right. Therefore, emergency surgery with diaphragmatic plasty and caesarian section were performed. After the operation, the patient’s respiratory condition recovered promptly and the serum amylase returned to normal range within 2 days. Her child The neonate also needed to be intubated because of neonatal respiratory distress syndrome. After treatment with pulmonary surfactant, however, the baby showed good recovery. Both the patient and her baby were discharged without any problems.