Mikami S, Kimura S, Tsukamoto Y, Hiwatari M, Hisatsune Y, Fukuoka A, Matsushita T, Enomoto T, Otsubo T. Combined laparoscopic and thoracoscopic repair of adult right-sided Bochdalek hernia with massive liver prolapse: A case report. World J Clin Cases 2024; 12(14): 2420-2425 [PMID: 38765754 DOI: 10.12998/wjcc.v12.i14.2420]
Corresponding Author of This Article
Shinya Mikami, MD, PhD, Professor, Department of Gastrointestinal and General Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Kanagawa 216-8511, Japan. s2mikami@marianna-u.ac.jp
Research Domain of This Article
Surgery
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Shinya Mikami, Sae Kimura, Yoshitsugu Tsukamoto, Masaki Hiwatari, Yasuhito Hisatsune, Asako Fukuoka, Tsunehisa Matsushita, Takeharu Enomoto, Takehito Otsubo, Department of Gastrointestinal and General Surgery, St. Marianna University School of Medicine, Kanagawa 216-8511, Japan
Author contributions: Mikami S provided patient information and wrote the manuscript; Mikami S, Kimura S, Matsushita T, Fukuoka A, and Enomoto T are the surgeons who performed the operation and evaluated the patient; Tsukamoto Y, Hiwatari M, and Hisatsune Y prepared the figures and collected the data; Otsubo T supervised the study; all authors have read and approved the final manuscript.
Informed consent statement: Informed consent was obtained from the patient for the publication of this case report and any accompanying images.
Conflict-of-interest statement: There are no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shinya Mikami, MD, PhD, Professor, Department of Gastrointestinal and General Surgery, St. Marianna University School of Medicine, 2-16-1 Sugao, Kanagawa 216-8511, Japan. s2mikami@marianna-u.ac.jp
Received: January 21, 2024 Revised: February 23, 2024 Accepted: April 1, 2024 Published online: May 16, 2024
Abstract
BACKGROUND
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.
CASE SUMMARY
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.
CONCLUSION
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.
