R Kennedy1, A Donaghy, J Ahmad, K McManus, W D B Clements. 1. Department of Upper Gastrointestinal Surgery, Royal Victoria Hospital, Belfast, BT12 6BA, Northern Ireland, UK. rpg.kennedy@btinternet.com
Abstract
BACKGROUND: A congenital diaphragmatic hernia (Bochdalek's hernia) rarely presents in adulthood. CASE PRESENTATION: We present the case of a 21-year-old woman with thrombocytopenia secondary to hypersplenism due to left-sided (sinistral) portal hypertension. This portal hypertension was caused by strangulation of the spleen within a Bochdalek's hernia. Subacute gastric volvulus compounded by portal hypertensive gastropathy resulted in her presentation with acute haematemesis. CONCLUSIONS: Congenital diaphragmatic hernias may present in the adult. Their presentation is variable, and they may produce life-threatening complications.
BACKGROUND: A congenital diaphragmatic hernia (Bochdalek's hernia) rarely presents in adulthood. CASE PRESENTATION: We present the case of a 21-year-old woman with thrombocytopenia secondary to hypersplenism due to left-sided (sinistral) portal hypertension. This portal hypertension was caused by strangulation of the spleen within a Bochdalek's hernia. Subacute gastric volvulus compounded by portal hypertensive gastropathy resulted in her presentation with acute haematemesis. CONCLUSIONS:Congenital diaphragmatic hernias may present in the adult. Their presentation is variable, and they may produce life-threatening complications.