Korean J Gastroenterol.  2018 May;71(5):290-293. 10.4166/kjg.2018.71.5.290.

An Unexpected Adverse Event during Colonoscopy Screening: Bochdalek Hernia

• Lee JS
• Kim ES
• Jung MK
• Kim SK
• Jin S
• Lee DH
• Seo JW

• KMID: 2415488
• DOI: http://doi.org/10.4166/kjg.2018.71.5.290

Abstract

Bochdalek hernia (BH) is defined as herniated abdominal contents appearing throughout the posterolateral segment of the diaphragm. It is usually observed during the prenatal or newborn period. Here, we report a case of an adult patient with herniated omentum and colon due to BH that was discovered during a colonoscopy. A 41-year-old woman was referred to our hospital with severe left chest and abdominal pain that began during a colonoscopy. Her chest radiography showed colonic shadow filling in the lower half of the left thoracic cavity. A computed tomography scan revealed an approximately 6-cm-sized left posterolateral diaphragmatic defect and a herniated omentum in the colon. The patient underwent thoracoscopic surgery, during which, the diaphragmatic defect was closed and herniated omentum was repaired. The patient was discharged without further complications. To the best of our knowledge, this case is the first report of BH in an adult found during a routine colonoscopy screening.

Keyword

Hernia, diaphragmatic; Colonoscopy; Screening

MeSH Terms

Abdominal Pain
Adult
Colon
Colonoscopy*
Diaphragm
Female
Hernia*
Hernia, Diaphragmatic
Humans
Infant, Newborn
Mass Screening*
Omentum
Radiography
Thoracic Cavity
Thoracoscopy
Thorax

Figure

• 

  Fig. 1. Colonoscopic view showing a narrowed and twisted lumen at the splenic flexure.

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  Fig. 2. (A) Chest radiography after colonoscopy showing colonic air shadow protruding into the left thoracic cavity. (B) Chest radiography before colonoscopy with normal results.

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  Fig. 3. Computed tomography scan showing a 6-cm-sized left posterolateral diaphragmatic defect and herniated omentum in the colon (arrow).

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  Fig. 4. Thoracoscopic view of the diaphragm. A diaphragmatic defect with herniated omentum in the colon in the thoracic cavity is observed.

Reference

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