La hernie diaphragmatique de Bochdalek étranglée: cause rare d’occlusion intestinale <span class="so-article-trans-title" dir="auto"> Translated title: Diaphragmatic strangulated Bochdalek hernia: a rare cause of intestinal obstruction </span>

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Abstract

La Hernie diaphragmatique de Bochdalek étranglée comme cause d’occlusion intestinale est très rare. Nous rapportons le cas d’un enfant de 18 mois ayant une hernie à manifestation tardive découverte au stade d’occlusion intestinale. L’enfant s’est présenté dans un tableau d’occlusion intestinale. La radiographie thoracoabdominale a montré la présence de clartés digestives en intrathoracique avec des niveaux hydroaeriques. L’exploration chirurgicale a objectivé une hernie postéro latérale gauche de Bochdalek avec étranglement du colon transverse et du grand épiploon. Le geste a consisté en la réduction des organes herniés avec fermeture du défect diaphragmatique. L’évolution est favorable avec un recul de 2 ans.

Most cited references 6

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Bochdalek diaphragmatic hernia: not only a neonatal disease.

D Trachsel, J K Langer, M Mei-Zahav … (2003)

To characterise the clinical manifestations of late presenting Bochdalek diaphragmatic hernia (DH), the incidence of misdiagnosis, and prognosis; and to explore the sequence of events that leads to this clinical picture. Retrospective chart review. All children with Bochdalek DH were identified. Children 1 month of age and older at the time of diagnosis were included. Twenty two children with Bochdalek DH met the inclusion criteria. Three clinical presentations could be defined. Fourteen children presented with acute onset of symptoms, predominantly vomiting and respiratory distress. Four had chronic non-specific gastrointestinal or respiratory symptoms, and in four the DH was found incidentally. Although five children were initially misdiagnosed, in 20 children (91%) the correct diagnosis was made on x ray examination. One child experienced a complicated course when the x ray picture was misinterpreted as pneumothorax. All children had favourable outcome. Two children had previously normal chest imaging, suggesting acquired herniation. A large pleural effusion without DH in a 9.5 year old girl with an abdominal infection prior to presenting with herniation suggests a pre-existing defect in the diaphragm. Late presenting Bochdalek DH can present with acute or chronic gastrointestinal, or less frequently, respiratory symptoms. It can also be found incidentally. Misdiagnosis can result in significant morbidity. Favourable outcome is expected when the correct diagnosis is made. The sequence of events is probably herniation of abdominal viscera through a pre-existing diaphragmatic defect. Although rare, DH should be considered in any child presenting with respiratory distress or with symptoms suggestive of gastrointestinal obstruction.

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Late presenting Bochdalek hernia containing colon: misdiagnosis risk.

C Treguier, Thomas M Chapuis, B Frémond … (1995)

The case of an eleven-months-old girl is reported: she entered the intensive care unit for fever, vomiting and left pleural effusion. Abdominal echography, CT scan and colonic opacification led to the diagnosis of a colonic Bochdalek hernia. A review of the literature showed that colonic hernias are rare, with only five previous reported cases in which colon was found in the thorax. The authors emphasise that there is a high risk of misdiagnosis due to the fact that small intestine contrast studies are normal; only colonic contrasting may lead to the right diagnosis. The roles of echography and CT scan are discussed.

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Late presentation of Bochdalek hernia: clinical and radiological aspects.

H Oztürk, S Cetinkurşun, M Sakarya … (2001)

Three infants with late presentation of Bochdalek hernia are presented. The presenting symptoms were cough, intermittent vomiting, dyspnea, and cyanosis. Initial diagnoses of isolated paravertebral mass and foreign material aspiration were made in two infants, based on plain chest x-ray findings and history of the patients. Further radiological investigations, such as contrast upper gastrointestinal series or enema, computerized tomography, and magnetic resonance imaging of the chest, suggested the diagnosis of Bochdalek hernia. The hernia was found on the left side in two patients and on the right side in one. At operation, the stomach, small intestine, and spleen were found as herniated organs in one patient, ascending colon in one, and all of the small intestine together with ascending colon in the other. A congenital diaphragmatic defect should be suspected in every child presenting with unusual respiratory or gastrointestinal symptoms and with abnormal chest x-ray findings. The radiological findings vary greatly from one case to another, and even in the same case at different times because of differences in herniated organs and intermittent spontaneous reduction. The possibility of congenital diaphragmatic hernia should be kept in mind to avoid a wrong diagnosis, undue delay in diagnosis, and inappropriate treatment. Copyright 2001 Wiley-Liss, Inc.

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Author and article information

Journal

Journal ID (nlm-ta): Pan Afr Med J

Journal ID (iso-abbrev): Pan Afr Med J

Journal ID (publisher-id): PAMJ

Title: The Pan African Medical Journal

Publisher: The African Field Epidemiology Network

ISSN (Electronic): 1937-8688

Publication date (Electronic): 18 March 2012

Publication date Collection: 2012

Volume: 11

Electronic Location Identifier: 48

Affiliations

[1 ]Service de Chirurgie Pédiatrique, Hôpital Mère-Enfant, CHU Hassan II, Fès, Maroc

Author notes

[& ]Corresponding author: Mahmoudi Abdelhalim, Service de Chirurgie Pédiatrique, Hôpital Mère-Enfant, CHU Hassan II, Fès, Maroc

Article

Publisher ID: PAMJ-11-48

PMC ID: 3343676

PubMed ID: 22593784

SO-VID: e0dd8b8b-5d53-4413-a631-d435dc2a915c

License:

The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.