Abstract

Diaphragmatic hernia is an extremely rare entity in adults, it is defined as the transposition of abdominal organs to the thoracic cage, through defects of the phrenic muscle. They can be classified as congenital or acquired. The incidence is reported to be 0.17%, with most hernias occurring on the left side. In Honduras there are few cases reported in pediatrics and one case reported in adults. 53-year-old male patient, farmer, from Tegucigalpa, Honduras. Who attended the Surgery Emergency at the Hospital Escuela Universitario? With a single history of chronic alcoholism, she presented stopping of evacuation of 10 days of evolution which channeled gases, accompanied by abdominal distention in turn, abdominal pain of 1 week of colic-like evolution, in the left iliac fossa irradiated to the flank and right hypochondrium, progressive insidious onset, of mild to moderate intensity, sometimes it did not remit with analgesics, accompanied by dyspnea from small to medium efforts and paroxysmal episodes of cough, without cyanosis. Abdomen: globose at the expense of adipose tissue, distended, on auscultation with abolished bowel sounds, tympanic percussion, with pain on superficial and deep palpation with involuntary muscular resistance. The chest radiograph showed the presence of intestinal and stomach loops in the left hemithorax. Abdominal radiographs show hydroaerous levels, with an image of a pile of coins, with dilated loops of the large intestine. After laparotomy, the patient presented a satisfactory evolution, with subsequent hospital discharge.

Keywords: Diaphragmatic hernia; Bochdalek; Abdominal obstruction