Bochdalek hernia presenting in adult life: report of an unusual case and review of the literature

Below, we present the case of a middle-aged woman with a symptomatic congenital posterior diaphragmatic (Bochdalek) hernia that remained undiagnosed for years. During the last attack, when she was referred to our institution, she had a large thoracic herniation of several abdominal viscera including the stomach, which was also rotated along its transverse axis (gastric volvulus). After a chest radiograph no time was wasted on further investigations and she was rushed to theatre for exploration through a midline laparotomy. The hernia was reduced, the viscera returned to the abdominal cavity and the process of strangulation arrested. A gastropexy was performed. The patient remains well on follow-up. It is important to be aware of the existence of congenital Bochdalek hernias presenting in adult life, with lethal complications if left untreated. In these situations prompt surgery is indicated and should be performed to restore the abdominal anatomy and repair the hernial defect.