# Symptomatic Left-Sided Bochdalek Hernia in the Adult: A Case Report and Literature Review

## TL;DR

An 81-year-old woman with a rare left-sided Bochdalek hernia was managed without surgery, highlighting the importance of early diagnosis and non-surgical options in adults.

## Contribution

This case report highlights conservative management of a symptomatic Bochdalek hernia in an elderly adult, a rare clinical scenario.

## Key findings

- An 81-year-old female with a Bochdalek hernia opted for conservative management instead of surgery.
- The case emphasizes the importance of clinical suspicion and prompt imaging in diagnosing Bochdalek hernias in older adults.
- Symptomatic management without surgical intervention is a viable option in selected adult cases.

## Abstract

A Bochdalek hernia, a type of diaphragmatic hernia, is a congenital hernia that typically presents on the left posterolateral diaphragm. It typically presents in early childhood as respiratory or gastrointestinal symptoms and diagnosis is confirmed by chest X-ray in pediatric patients. In many cases, treatment is surgical with mesh-based hernia repair. In children, surgical treatment is performed to prevent complications of pulmonary hypoplasia; whereas, in adults, surgical correction of the hernia is done for symptomatic management. We present a case of an 81-year-old female who came in with complaints of shortness of breath, nausea and vomiting, who was diagnosed with Bochdalek hernia on abdominal CT. Although a candidate for surgery, the patient decided to pursue conservative management. Our case emphasizes the importance of clinical suspicion and prompt imaging diagnosis in cases of older patients presenting with respiratory or gastrointestinal symptoms; this case also demonstrates management of Bochdalek hernia without surgical intervention.