Abstract

DIAZ RINCON, Camilo  and  GOMEZ PAREJA, Cristian. Strangulation of stomach in volvulus. rev. colomb. cir. [online]. 2008, vol.23, n.2, pp.117-122. ISSN 2011-7582.

Objective. To report a case of gastric strangulation in secondary volvulus due to Bochdalek hernia in an adult patient. Introduction. Congenital diaphragmatic hernia occurs in approximately 1 in 3,000 births, and Bochdalek hernia (the most frequent type) in 1 in 5,000 births. Bochdalek hernia is extremely rare in adults, with an incidence not higher than 10% of the total of congenital diaphragmatic hernias. Gastric volvulus is an infrequent entity, generally associated with diaphragmatic hernia. There have been about 100 cases of strangulation secondary to Bochdalek hernia reported in the literature. Clinical case. Firty one year-old man presenting with intense abdominal pain, associated with vomiting, absence of stools, abdominal distension, diminished bowel sounds, and tenderness over the epigastrium and hypogastrium. Radiographs of chest and abdomen revealed a diaphragmatic hernia; there was no history of trauma. Because of signs of peritoneal irritation, he was submitted to exploratory laparotomy; necrosis of the stomach was found, due to the hernia. Subtotal gastrectomy was performed with a Roux en-Y reconstruction and diaphragmatic hernorraphy and chest tube rainage, without the use of mechanical sutures. Postoperative recovery was satisfactory.

Keywords : stomach volvulus; hernia; diaphragmatic; surgery.

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