Adult Bochdalek hernia following living donor left hepatectomy repaired by thoracoscopy‐assisted surgery: A case report

• Published in: Asian journal of endoscopic surgery Vol. 15; no. 1; pp. 220 - 224
• Main Authors: Takagi, Kosei, Kuise, Takashi, Yoshida, Kazuhiro, Yoshida, Ryuichi, Umeda, Yuzo, Fujiwara, Toshiyoshi, Yagi, Takahito
• Format: Journal Article
• Language: English
• Published: Kyoto, Japan John Wiley & Sons Australia, Ltd 01.01.2022; Wiley Subscription Services, Inc
• Subjects: Adult; Bochdalek hernia; Case reports; Hepatectomy; Hernias; Hernias, Diaphragmatic, Congenital - diagnostic imaging; Hernias, Diaphragmatic, Congenital - surgery; Humans; left hepatectomy; living donor; Living Donors; Male; Surgery; Thoracoscopy; Tomography, X-Ray Computed; living donor; left hepatectomy; Bochdalek hernia
• DOI: 10.1111/ases.12981
• ISSN: 1758-5902

Bochdalek hernia is a congenital diaphragmatic hernia (DH). Herein, we report a case of adult Bochdalek hernia following living donor hepatectomy repaired by thoracoscopy‐assisted surgery. A 36‐year‐old man underwent living donor left hepatectomy. Four months later, the patient presented with acute epigastric pain. Computed tomography found the left‐sided DH in which the stomach was incarcerated into the pleural cavity without ischemic changes. As endoscopic intervention was unsuccessful, the herniated stomach was repositioned by thoracoscopy‐assisted surgery. The 3‐cm hernia orifice was found to have a smooth edge with no hernia sac, suggesting Bochdalek hernia, and the defect was primarily closed. The patient was followed up for 20 months without hernia recurrence. This is the first presentation of a case of Bochdalek hernia following donor hepatectomy. In cases of early detected DH, primary repair via a transthoracic approach with thoracoscopy‐assisted surgery is safe and feasible.