LAPAROSCOPIC REPAIR OF A LEFT BOCHDALEK HERNIA IN AN ADULT

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Abstract Introduction Congenital diaphragmatic hernias have an incidence of 1 in 2000 to 1 in 3000 births. Of them, about 70% are postero-lateral defects (Bochdalek hernias BH). Most of them are symptomatic in newborns with respiratory complaints. In adults, they can produce vague or nonspecific gastrointestinal complaints. When a BH is diagnosed in adult patients, surgery is recommended when it is symptomatic or even asymptomatic, when the patient is fit for surgery. Material and method We present the case of a 53 African male with the incidental diagnosis of a BH in a thoracic CT scan with fat and splenic colon in the hernia. A laparoscopic approach was performed. The hernia was dissected with the reduction of the viscera and the visualization of the diaphragm. We performed a suture of the diaphragmatic edges, and a coated mesh was used to reinforce the diaphragm. The mesh was fixed with resorbable tuckers in the lower part and with barbed suture in the upper part. The patient was discharged 24 hours after surgery. Discussion BH has risk of growing because of the negative pressure of the thorax. The risk of an incarceration of a viscera in the thorax can develop serious complications. Laparoscopic approach is a minimally invasive access that allows a good repair of diaphragmatic hernias with a fast recovery. For theses reasons we recommend laparoscopic repair of BH.

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