Congenital posterolateral diaphragmatic hernia in the adult.

Five adult patients with the Bochdalek type of congenital diaphragmatic hernia are presented. Four of the hernias were on the left side and one on the right. One of the patients was asymptomatic, while 3 of them had gastrointestinal symptoms. In 2 of these 3 cases, the symptoms became worse when the patients were lying down. One patient complained mostly of dyspnoea, and also had a patent ductus arteriosus. The other anomaly, in addition to hernia, was diaphragmatic pulmonary sequestration. All the patients were operated on transthoracally. In one case, laparotomy was also performed. There was no strangulation in any of the cases. No operative or postoperative complications occurred. A complete roentgenologic examination including chest X-ray, barium meal, barium enema, and sometimes pneumoperitoneum may be needed in order to make an accurate diagnosis preoperatively. Because of the strangulation danger operation is recommended whenever the diagnosis is made.