Case Report
Copyright ©2006 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 21, 2006; 12(15): 2469-2471
Published online Apr 21, 2006. doi: 10.3748/wjg.v12.i15.2469
Bochdaleck’s hernia complicating pregnancy: Case report
Nikolaos Barbetakis, Andreas Efstathiou, Michalis Vassiliadis, Theocharis Xenikakis, Ioannis Fessatidis
Nikolaos Barbetakis, Andreas Efstathiou, Michalis Vassiliadis, Theocharis Xenikakis, Ioannis Fessatidis, Department of Cardiothoracic Surgery, Geniki Kliniki - Euromedica, Paraliaki Ave and Gravias 2, Thessaloniki, Greece
Correspondence to: Dr. Nikolaos Barbetakis, P. Mela 5-7, Triandria Thessaloniki 55337, Greece.
Telephone: +30 6972039345
Received: December 3, 2005
Revised: January 2, 2006
Accepted: January 14, 2006
Published online: April 21, 2006

Diaphragmatic hernia complicating pregnancy is rare and results in a high mortality rate, particularly if early surgical intervention is not undertaken. We report a case in which a woman presenting at 23 wk’s gestation was admitted with symptoms of respiratory failure and bowel obstruction due to incarceration of viscera through a left posterolateral defect of the diaphragm (Bochdalek’s hernia). Surgery (left thoracoabdominal incision) demonstrated compression atelectasis, mediastinal shift, strangulation and gangrene of the herniated viscera which led to segmental resection of the involved portion of large intestine with re-establishment of bowel continuity by end to end anastomosis. The greater omentum was partly necrotic necessitating resection. The diaphragmatic defect was closed with interrupted sutures. Postoperative period was uncomplicated. Pregnancy was allowed to continue until 39 wk’s gestation at which time elective cesarean delivery was performed. It is concluded that symptomatic maternal diaphragmatic hernia during pregnancy is a surgical emergency and requires a high index of suspicion.

Keywords: Pregnancy, Diaphragmatic hernia, Incarceration