CASE REPORT: PDF OnlyAdult Bochdalek Hernia with Bowel IncarcerationHung, Yeh-Huanga; Chien, Yu-Honb, *; Yan, Sheng-Leia; Chen, Ming-FengaAuthor Information aDivision of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Bing Show Chwan Hospital, Taiwan, R.O.C. bDepartment of Internal Medicine, Chang Bing Show Chwan Hospital, Chunghua, Taiwan, R.O.C. *Correspondence to: Dr Yu-Hon Chien, Department of Internal Medicine, Chang Bing Show Chwan Hospital, 6, Lugong Road, Lukang Zhen, Changhua 505, Taiwan, R.O.C. E-mail: [email protected] Received: January 18, 2008; • Accepted: May 15, 2008. Journal of the Chinese Medical Association: October 2008 - Volume 71 - Issue 10 - p 528-531 doi: 10.1016/S1726-4901(08)70162-X Metrics Abstract Bochdalek hernias are rare in adults. We report 2 cases of Bochdalek hernia with bowel obstruction. The first case was a 74-year-old male patient who suffered from abdominal pain and chest tightness for 1 day. Chest radiography indicated a mass-like lesion above the left diaphragm. The pain could not be relieved by nasogastric tube decompression for 12 hours. We arranged computed tomography, which revealed a dilated bowel above the diaphragm and intestinal obstruction with gangrenous change. The patient received emergency laparotomy, and a Bochdalek hernia was detected during the operation. The second case was a 75-year-old female patient who suffered from chest tightness and dyspnea for about 1 week. Chest X-ray and magnetic resonance imaging revealed herniation of small and large bowels at the right posterior aspect of the thoracic cavity. She received transthoracic repair of diaphragmatic hernia, recovered, and was discharged 15 days later. We recommend that adult Bochdalek hernia should be considered in the differential diagnosis of bowel obstruction. © 2008 by Lippincott Williams & Wilkins, Inc.