Bilateral Bochdalek Hernias Presenting as Respiratory Failure in an Elderly Patient

• Published in: Respiratory care Vol. 56; no. 5; pp. 691 - 694
• Main Authors: ALVIAR, Carlos L, CORDOVA, Juan P, KORNIYENKO, Aleksandr, JAVED, Fahad, TSUKAYAMA, Miguel, NARAYANSWAMI, Gopal
• Format: Journal Article
• Language: English
• Published: Irving, TX Daedalus 01.05.2011; Daedalus Enterprises, Inc
• Subjects: Aged, 80 and over; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Case studies; Causes of; Demographic aspects; Diagnosis, Differential; Diaphragm; Emergency and intensive respiratory care; Female; Hernia; Hernia, Diaphragmatic - complications; Hernia, Diaphragmatic - diagnosis; Hernias, Diaphragmatic, Congenital; Humans; Intensive care medicine; Medical sciences; Respiratory insufficiency; Respiratory Insufficiency - diagnosis; Respiratory Insufficiency - etiology; Tomography, X-Ray Computed; Human; Diaphragmatic hernia; Intensive care; Respiratory failure; Respiratory disease; Bochdalek; Elderly; Resuscitation
• ISSN: 0020-1324; 1943-3654
• DOI: 10.4187/respcare.00817

Bochdalek hernia occurs from a congenital defect of the diaphragm, allowing the passage of abdominal structures into the thoracic cavity, limiting lung expansion and ventilatory function. Bochdalek hernia is common in neonates but rarely occur in adults; there are only 4 documented cases in the elderly population. We present a case of an 88-year-old woman with severe hypoxia and respiratory failure that required ventilatory support, in whom bilateral Bochdalek hernias progressed over the years and severely invaded the thoracic cavity, causing acute decompensation. This is a rare condition in adults but can cause substantial morbidity when the involvement of the thoracic cavity is severe.