Bochdalek Hernia in an Adult with Pan-pleuritis and Peritonitis Secondary to Stomach Perforation—A Case Report—

Abstract

A 29-year-old woman presented with a 3-year history of postprandial pain and a 2-day history of stomachache and nausea. Thoracoabdominal computed tomography revealed prolapse of the dilated stomach into the left thoracic cavity. Emergent laparotomy was performed several hours after hospitalization, because the patient was hemodynamically unstable in a state of shock. Intraoperatively, we observed that most of the stomach had prolapsed into the left thoracic cavity through a left-sided diaphragmatic hernia defect. Contaminated ascitic fluid and pleural effusion spread to the thoracic cavity through this stomach perforation. We removed the ischemic and perforated portions of the stomach and subsequently closed the gastric and diaphragmatic defects. We diagnosed the diaphragmatic defect as a Bochdalek hernia. The patient developed thoracic empyema, preperitoneal abscess, and surgical wound infection. However, these postoperative complications resolved following treatment, and she was discharged 31 days after admission. We report a case of Bochdalek hernia with gastric perforation along with a discussion of the relevant literature.