ĐẶC ĐIỂM LÂM SÀNG VÀ KẾT QUẢ PHẪU THUẬT THOÁT VỊ HOÀNH (BOCHDALEK) BẨM SINH XUẤT HIỆN MUỘN

Abstract

Study aim: 1. Evaluation of clinical and paraclinical feature of Congenital diaphragmatic hernia (Bochdalex). 2. Surgical results of diaphragmatic hernia Bochdalex. Results: There were 6 patients, female 66,7%, male 33,3%, mean age 39 year olds, abdominal pains and dyspnea  in 66,7%. Plain abdominal X ray performed  in 100%; CTScan multislide performed  in 100%. Emergency operation in 66,7% due to hernial strangulation, elective surgery in 33,3%; the left side hernia was 83,3%, right side hernia in one patient. The average diameter of hernial  hole was 11,3-7 cm. Open surgery was performed in 83,3%; Surgical procedure included: Reduction of hernial contents to peritoneal cavity and repair of diaphragmatic defect: Laparotomy in 83,3%, laparoscopy in 1 patient; Suture of defect in 2 cases; prosthetic graft placement (mesh) in 66,7%. One patient ded of septic shock due to hernial intestinal strangulation (intrathoracic necrosis and perfogation), No complication per and post operation. Conclusion: Congenital Bochdalex hernia in adult is extremely rare and left congenital hernias are more common than right side hernias (83,3%-16,7%). The main symptoms were abdominal pains, vomit  with dispnea (66,7%). Diagnosis by plain abdominal Xray, chest Xray, barium examination; CTscan multislide... Surgical procedure includes reduction of hernial content to abdominal cavity and repair of defect by suture or mesh placement (laparoscopy or laparotomy).