A Case of Incarcerated Bochdalek Hernia in an Overweight High-school Student

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Here, we present a rare case of adult Bochdalek hernia in a 15-year-old overweight male (body mass index=35) who was presented to a nearby hospital with the complaints of upper abdominal pain and vomiting. Computed tomography showed a large whole stomach, transverse colon, and greater omentum in the left thoracic cavity. The patient was referred to our hospital and an emergency operation was performed, yielding a diagnosis of incarcerated Bochdalek hernia. Laparoscopic surgery was initiated but it was difficult to proceed with this action because of the patient's morbid obesity ; therefore, we opened the abdomen, repaired the incarceration, and closed hernial opening with direct sutures. The patient's postoperative course was uncomplicated and he was discharged from the hospital on postoperative day 13. No relapse has occurred. In this case, the Bochdalek hernia may have developed due to chronic abdominal pressure related to the patient's obesity. Adult Bochdalek hernia has been considered to be a rare disorder, but the incidence may be higher than reported due to asymptomatic cases. The mortality rate is high when any sudden change occurs in patients with this type of hernia ; thus, early detection and appropriate therapy are important.