Surgical treatment of adult right-sided giant Bochdalek hernia

Bochdalek hernia is a congenital diaphragmatic hernia typically arising from developmental defects in the diaphragm, allowing abdominal organs to protrude into the thoracic cavity. It primarily affects neonates, with adult cases being rare. This report presents a 19-year-old male with a right-sided Bochdalek hernia containing the liver, gallbladder, and colon, causing compression of the right lung and mediastinum, resulting in respiratory distress. CT imaging illustrated the extent of the herniated organs and their impact on thoracic structures. A combined abdominal and thoracic approach was utilized, including adhesiolysis, reduction of herniated organs, and repair of the diaphragmatic defect with a composite mesh. Postoperatively, the patient showed significant respiratory improvement and experienced a favorable recovery. This case underscores the need to consider Bochdalek hernia in adults with unexplained respiratory distress and abnormal imaging findings.