Annali italiani di chirurgia · 2019
An unusual case of gastric volvulus through Bochdalek hernia A case report and review of the recent literature.
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Rossitto Maurizio, Viscosi Francesca, Trovato Massimo, Cucinotta Eugenio, Mazzeo Carmelo
Аннотация
INTRODUCTION: Bochdalek Hernias are one of the most common types of diaphragmatic hernia, a congenital pathology diagnosed during the neonatal period. In adulthood, diagnosis of a Bochdalek hernia is rare and its complications may be fatal.
CASE REPORT: We report an unusual case of a 60-year-old woman who presented with upper gastrointestinal bleeding due to a Bochdalek hernia with herniation of stomach and spleen into the chest with a gastric volvulus. Endoscopy showed a strong suspicion of ischemic suffering of the stomach walls, therefore the patient was subjected to urgent laparotomy. The content was reduced, the stomach was congested but viable and the diaphragmatic hernia defect was closed with interrupted sutures.
DISCUSSION: Bochdalek hernia in an adult may present with a myriad of abdominal symptoms, such as recurrent abdominal pain, postprandial fullness, and vomiting. The hernia size varies and the content of the hernial sac may differ in each case. The sac may contain multiple viscera including the small bowel, colon, stomach and spleen. As in our case, strangulation of the herniated stomach can occur and this condition can lead to gastric perforation, sepsis and even DEATH.
CONCLUSIONS: Considering the severity of this condition, accurate diagnosis and timely surgical treatment is mandatory to reducing morbidity and mortality.
KEY WORDS: Bochdalek hernia, Gastric volvulus.
CASE REPORT: We report an unusual case of a 60-year-old woman who presented with upper gastrointestinal bleeding due to a Bochdalek hernia with herniation of stomach and spleen into the chest with a gastric volvulus. Endoscopy showed a strong suspicion of ischemic suffering of the stomach walls, therefore the patient was subjected to urgent laparotomy. The content was reduced, the stomach was congested but viable and the diaphragmatic hernia defect was closed with interrupted sutures.
DISCUSSION: Bochdalek hernia in an adult may present with a myriad of abdominal symptoms, such as recurrent abdominal pain, postprandial fullness, and vomiting. The hernia size varies and the content of the hernial sac may differ in each case. The sac may contain multiple viscera including the small bowel, colon, stomach and spleen. As in our case, strangulation of the herniated stomach can occur and this condition can lead to gastric perforation, sepsis and even DEATH.
CONCLUSIONS: Considering the severity of this condition, accurate diagnosis and timely surgical treatment is mandatory to reducing morbidity and mortality.
KEY WORDS: Bochdalek hernia, Gastric volvulus.