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Research: A Tale of Two Congenital Lesions: A Case Report of Congenital Diaphragmatic Hernia and Congenital Heart Disease Managed by Successful Surgical Outcome With Review of the Literature (Bhende-Pathak Hernia)

Updated on 3 min read

Cureus

. 2024 Dec 6;16(12):e75238.

 doi: 10.7759/cureus.75238. eCollection 2024 Dec. https://pubmed.ncbi.nlm.nih.gov/39649237/

A Tale of Two Congenital Lesions: A Case Report of Congenital Diaphragmatic Hernia and Congenital Heart Disease Managed by Successful Surgical Outcome With Review of the Literature (Bhende-Pathak Hernia)

Vishal V Bhende 1, Mahesh H Bhatt 2, Viral B Patel 3, Rahul Tandon 4, Mathangi Krishnakumar 5

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Abstract

Congenital diaphragmatic hernia (CDH) is a diaphragmatic defect that is usually situated on the left side in the posterolateral region, named a Bochdalek hernia (BH), which allows abdominal organs to herniate into the thoracic cavity. BH is a prevalently observed birth anomaly in infants but is rare in adults. Right-sided BH that involves the colon is exceptionally rare, and no prior cases have described ileocecal appendix involvement. Here, we present a case of a preschooler with a right-sided BH and patent ductus arteriosus (PDA), requiring distinct surgical approaches: left open thoracotomy for PDA ligation and right open thoracotomy for CDH repair. Surgical intervention is associated with reduced morbidity and mortality, favorable long-term outcomes, and a low recurrence rate, irrespective of the selected approach. Reinforcement through suture repair with mesh application, as well as PDA ligation, reinforced with metallic clips as the preferred surgical operation in this case. To the best of our knowledge, this is the first reported instance of a pediatric patient with right-sided BH that involves the appendix, alongside concurrent congenital heart disease (CHD). We propose the term Bhende-Pathak hernia for this pediatric variant.

Keywords: bochdalek’s hernia; congenital diaphragmatic hernia; congenital heart disease; diaphragm; ileo-caecal appendix; mesh repair; patent ductus arteriosus; pulmonary hypoplasia; surgical ligation of patent ductus arteriosus; • bhende-pathak hernia.

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