Association of intestinal malrotation and Bochdalek hernia in an adult: a case report

BMC Research Notes

Caldeira Fradique¹  Eusébio Porto¹  Francisco V Sousa¹  Bárbara Paredes¹  Celso Nabais¹  Raquel Salústio¹ 

[1] Department of Surgery, Hospital de São José, Centro Hospitalar de Lisboa Central, Serviço de Cirurgia 1, Rua José António Serrano, 1150-199 Lisboa, Portugal

关键词: Small bowel obstruction;    Intestinal malrotation;    Bochdalek hernia;   

Others  :  1132764
DOI  :  10.1186/1756-0500-7-296

 received in 2014-02-04, accepted in 2014-05-09,  发布年份 2014

【 摘 要 】

Background

Late presentations of congenital diaphragmatic hernia are rare and differ from the classic neonatal presentation. The association with other congenital malformations in children, mainly intestinal malrotation, is well documented. The diagnosis of this association in adults is very rare, and depends on a high degree of suspicion.

Case presentation

We report a case of a 50-year-old female Caucasian patient with a previous history of intestinal malrotation diagnosed in adolescence and treated conservatively. She was referred to the hospital with signs and symptoms of intestinal obstruction. The patient undertook computed tomography that confirmed small bowel obstruction with no obvious cause, and a right subphrenic abscess with right empyema was also present. An exploratory laparotomy was performed that revealed an intestinal malrotation associated with a right gangrenous and perforated Bochdalek hernia. Resection of the affected small bowel, closure of the Bochdalek foramen and the Ladd procedure were carried out.

Conclusion

This case shows a rare association of two rare conditions in adults, and highlights the challenge in reaching the diagnosis and management options.

【 授权许可】

   
2014 Salústio et al.; licensee BioMed Central Ltd.

【 图 表 】

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