Abstract
The patient was a woman in her thirties complaining of chest and epigastric pain. She developed epigastric pain in mid-April 2008, and visited our hospital because of exacerbation of the symptom and the onset of chest pain. A chest X-ray revealed accumulation of a gastric air bubble and gastric contents in the pleural cavity. Upper gastrointestinal endoscopy showed a recess in the stomach lumen. When the recessed area was endoscopically visualized by injecting contrast medium through a cannula, inflow of contrast medium was observed at an area consistent with the location of the gastric air bubble found on the chest X-ray. Based on these findings, the patient was diagnosed with incarcerated Bochdalek hernia of the stomach. A drainage tube was placed at the site of incarceration, and emergency surgery was performed on the day after admission. Using thoracoscopy, adhesions between the hernial orifice and the incarcerated stomach and greater omentum were detached, and using laparoscopy, the hernia contents were reduced into the abdominal cavity. The hernial orifice was thoracoscopically closed. Symptoms that had been present before surgery resolved postoperatively, and have not recurred thereafter.
We report a patient with incarcerated Bochdalek hernia for whom combined use of thoracoscopy and laparoscopy enabled safe surgery and produced favorable results.
