Case Report
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World J Gastrointest Surg. Jul 27, 2013; 5(7): 222-223
Published online Jul 27, 2013. doi: 10.4240/wjgs.v5.i7.222
An 81-year-old gentleman with symptomatic Bochdalek hernia
Mohammed Zak Rajput, Piero Marco Fisichella
Mohammed Zak Rajput, Piero Marco Fisichella, Swallowing Center, Department of Surgery, Loyola University Medical Center, Maywood, IL 60153, United States
Author contributions: Rajput MZ contributed to drafting maniscript; Fisichella PM contributed to critical review.
Correspondence to: Piero Marco Fisichella, MD, FACS, Swallowing Center, Department of Surgery, Loyola University Medical Center, South 1st Ave, Maywood, IL 60153, United States. pfisichella@lumc.edu
Telephone: +1-708-3272820 Fax: +1-708-3273492
Received: April 9, 2013
Revised: May 9, 2013
Accepted: June 5, 2013
Published online: July 27, 2013
Processing time: 94 Days and 4.8 Hours
Abstract

An 81-year-old gentleman with congenital polycystic kidney disease presented to his primary care physician with dysphagia, gastroesophageal reflux refractory to medical management, and 11.25 kg weight loss in a 6 mo-period. A barium swallow misdiagnosed a paraesophageal hernia for a Bochdalek hernia. Herein, we highlight how a Bochdalek hernia may be disregarded in the differential diagnosis and how providers can resort to a more common diagnosis, a paraesophageal hernia, which is more frequently encountered in old age and whose radiologic appearance might mimic a Bochdalek hernia.

Keywords: Polycystic kidney disease; Paraesophageal hernia; Bochdalek hernia; Diaphragmatic hernia; Diaphragmatic hernia repair

Core tip: Bochdalek hernias are seldom encountered in elderly patients. Hence, our goal is to briefly shed light on this less common hernia of the diaphragm and highlight its diagnosis and current treatment options, which are very different from that of a paraesophageal hernia, a common misdiagnosis.