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Laparoscopic repair of Bochdalek hernia with intrathoracic kidney and concomitant redo-redo incisional hernia.

BMJ Case Rep

January 2025

Faculty of Medicine, Department of Surgery, King Chulalongkorn Memorial Hospital, The Thai Red Cross Society, Chulalongkorn University, Bangkok, Thailand.

Bochdalek hernias (BHs), though rare, are the most common congenital diaphragmatic hernias. Their coexistence with an ectopic intrathoracic kidney (IK), found in 0.25% of cases, is even rarer.

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Internal hernias are one of the rare causes of intestinal obstruction and usually is the diagnosis of exclusion. Para-duodenal hernias (PDH) are rare congenital disorders that occur due to malrotation of the midgut in the embryonic phase of development. They can be asymptomatic or can present as an incarcerated, strangulated, or even obstructed internal hernia.

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This case report presents a unique clinical presentation of small bowel obstruction secondary to congenital partial malrotation of the gut in adults. Partial malrotation may have variable clinical presentations and this case highlights a constellation of patient history, radiographic signs, and operative findings leading to appropriate diagnosis and successful surgical management. A 56-year-old female patient presented with severe abdominal pain, nausea, and anorexia.

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Background And Aims: Morgagni hernias are rare congenital diaphragmatic defects that can lead to bowel obstruction and incarceration if not repaired. While this disease typically manifests as respiratory distress, frequent respiratory infections, and infant growth failure, it can sometimes be accidentally discovered in adulthood through cross-sectional imaging. We aimed to report our experience managing this entity during 20 years at our referral center.

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Introduction: Growing evidence supports the success of nonoperative management (NOM) for pediatric adhesive small bowel obstruction (A-SBO). However, there is concern that patients with nonadhesive SBO (NA-SBO) will have repeat episodes of SBO if not treated with surgery upfront. We examined whether NOM of NA-SBO at initial presentation was associated with increased risk of recurrent SBO.

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