Congenital Diaphragmatic Hernia in Adult Presenting with Obstruction: A Rare Case

Congenital diaphragmatic hernia occurs in 1 out of every 2000-3000 live births. A majority of the patients will be diagnosed either antenatally or will present with respiratory distress in the first few hours of life. Presentation in adults is extremely rare and accounts for about 5-25% of diaphragmatic hernias. Patients, who present with late diaphragmatic hernias, complain of a wide variety of symptoms and diagnosis can be difficult. We report a case of a 43-year-old male who presented with intestinal obstruction and acute onset of shortness of breath. Radiological imaging was done, and the diagnosis of left diaphragmatic hernia was made. The patient underwent an emergency operation through a thoraco-abdominal approach and the contents, which is the small intestine, omentum, portion of the stomach and transverse colon was reduced. The diaphragmatic defects were multiple, largest defect measures 5 cm x 8 cm, and primary repair was done. In addition, a prolene mesh was reinforced over the defect. Post-operative period was uneventful and patient remains well at follow-up.