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<p>Congenital diaphragmatic hernias (CDH) are rare in adults, with Bochdalek hernia (BH) being the most common. We report an unusual case of left-sided BH in a 56-year woman who presented with upper abdominal pain and intermittent vomiting. Initial imaging suggested a paraesophageal hiatal hernia (PEH) with possible gastric volvulus and no evidence of gastric perforation. During laparoscopic exploration, a diaphragmatic defect lateral to the left crus was identified, leading to a diagnosis of BH with an incarcerated stomach and gastric perforation. The herniated stomach was reduced, the perforation was repaired, and the diaphragmatic defect was closed using a prolene mesh. Differentiating between BH and PEH in adults is difficult when the gastric fundus herniates into the thoracic cavity. A high index of suspicion for complications is required in symptomatic patients, particularly when hollow viscus is involved. The laparoscopic approach is a safe and feasible option for this condition.</p>

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Congenital Diaphragmatic Hernia with Gastric Perforation in an Adult Masquerading as a Paraesophageal Hernia

  • 期刊论文

  • 发表日期：

    2026年3月2日

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  • Aaina Aggarwal,
  • Meghana Sharma,
  • Sanjay Gupta,
  • A. K. Attri

摘要

Congenital diaphragmatic hernias (CDH) are rare in adults, with Bochdalek hernia (BH) being the most common. We report an unusual case of left-sided BH in a 56-year woman who presented with upper abdominal pain and intermittent vomiting. Initial imaging suggested a paraesophageal hiatal hernia (PEH) with possible gastric volvulus and no evidence of gastric perforation. During laparoscopic exploration, a diaphragmatic defect lateral to the left crus was identified, leading to a diagnosis of BH with an incarcerated stomach and gastric perforation. The herniated stomach was reduced, the perforation was repaired, and the diaphragmatic defect was closed using a prolene mesh. Differentiating between BH and PEH in adults is difficult when the gastric fundus herniates into the thoracic cavity. A high index of suspicion for complications is required in symptomatic patients, particularly when hollow viscus is involved. The laparoscopic approach is a safe and feasible option for this condition.