Bochdaleck's hernia complicating pregnancy: Case report

作     者：Nikolaos Barbetakis Andreas Efstathiou Michalis Vassiliadis Theocharis Xenikakis Ioannis Fessatidis 

作者机构：Department of Cardiothoracic Surgery Geniki Kliniki-EuromedicaParaliaki Ave and Gravias 2ThessalonikiGreece 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2006年第12卷第15期

页      面：2469-2471页

核心收录：

学科分类：1002[医学-临床医学] 100210[医学-外科学(含：普外、骨外、泌尿外、胸心外、神外、整形、烧伤、野战外)] 100211[医学-妇产科学] 10[医学] 

主　　题：Pregnancy Diaphragmatic hernia Incarceration 

摘      要：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.