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Association of intestinal malrotation and Bochdalek hernia in an adult: a case report.
[congenital diaphragmatic hernia]
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
.
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
.
This
case
shows
a
rare
association
of
two
rare
conditions
in
adults
,
and
highlights
the
challenge
in
reaching
the
diagnosis
and
management
options
.
