Published online May 16, 2024. doi: 10.12998/wjcc.v12.i14.2420
Revised: February 23, 2024
Accepted: April 1, 2024
Published online: May 16, 2024
Processing time: 104 Days and 23.3 Hours
A Bochdalek hernia (BH) is a congenital diaphragmatic hernia that often develops in the neonatal period. BH typically occurs on the left side of the diaphragm. A right-sided BH in an adult is rare.
A 45-year-old man was referred to our hospital because of an abnormal shadow seen on chest radiography during a medical check-up. A chest radiograph showed elevation of the right hemidiaphragm. Computed tomography showed prolapse of multiple intraabdominal organs into the right thoracic cavity, corresponding to a right-sided BH. The herniated contents included the stomach, transverse colon, and left lobe of the liver. The left lobe of the liver was enlarged, particularly the medial segment. Laparoscopic surgery was performed. However, the left lobe of the liver was completely trapped in the thoracic cavity. Therefore, thoracoscopic manipulation had to be performed to return the liver to the abdominal cavity. The hernia was repaired with interrupted nonabsorbable sutures and reinforced with mesh.
Combined laparoscopic and thoracoscopic surgery was successfully performed for right-sided BH with massive liver prolapse and abnormal liver morphology.
Core Tip: Bochdalek hernia in adults is rare, especially on the right side. We report an extremely rare case of an adult with a right-sided Bochdalek hernia in which the left lobe of the liver protruded into the right thoracic cavity. We successfully performed a combined laparoscopic and thoracoscopic surgery for an adult right-sided Bochdalek hernia with massive liver prolapse and abnormal liver morphology. The combination of laparoscopic and thoracoscopic surgery enabled safe surgery. To our knowledge, no such cases have ever been reported previously.