Document Detail

Recurrent indigestion in a young adult.
MedLine Citation:
PMID:  21326883     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Bochdalek hernias (BHs) arise due to congenital diaphragmatic defect and can result in gross displacement of abdominal tissues into the thorax. Although they are uncommon in occurrence, they usually present as serious respiratory distress in infants. In the adult population, they are asymptomatic and only detected incidentally. In this report, we present the case of a 26-year-old male who acutely presented with severe epigastric pain radiating to the back and deranged vital signs as a result of incorrect previous diagnoses. A large left diaphragmatic hernia containing his pancreatic tail, spleen, stomach and other intra-abdominal organs was confirmed by CT scan, together occupying a third of the hemithorax. Although not common, diagnostics of BHs should be considered in patients presenting with acute abdomen. A plain chest X-ray displaying diminished left diaphragmatic outline or signs of mediastinal shift should raise suspicion. Previous normal chest X-ray can be deceptive and does not rule out a diaphragmatic hernia. Herein, we also review the literature for previously reported acute presentation of 11 similar cases in adults and highlight the value of including BH as one of the differential diagnoses.
Erdinc Soylu; Sameer Junnarkar; Hemant M Kocher
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Publication Detail:
Type:  Journal Article     Date:  2010-12-01
Journal Detail:
Title:  Case reports in gastroenterology     Volume:  4     ISSN:  1662-0631     ISO Abbreviation:  Case Rep Gastroenterol     Publication Date:  2010  
Date Detail:
Created Date:  2011-02-17     Completed Date:  2011-07-14     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101474819     Medline TA:  Case Rep Gastroenterol     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  518-23     Citation Subset:  -    
Barts and the London School of Medicine and Dentistry, The Royal London Hospital, London, UK.
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