case_images: PMC10251140_01
case_images: Case 1: (A) The thoracic x-ray is showing a left thoracic opacity up to the aortic arch; (B) the corresponding thoraco-abdominal CT in the frontal view showing the presence of intestinal content in the left thoracic cage; and (C) the herniated intestinal content following left thoracotomy.
case_images: fsurg-10-1150241-g001.jpg
case_images: PMC10251140_01_fsurg-10-1150241-g001.jpg
case_images: F1
case_images: A thoracic x-ray found a right opacity up to the aortic arch (Figure 1). A thoraco-abdominal CT showed the presence of nearly the entire small bowel, the left colic angle with part of the transverse and left colon, and the spleen, herniated in the left thoracic cage (Figure 1). A left thoracotomy was first performed (Figure 1).
case_images: PMC10251140_02
case_images: Case 2: (A) The pre-operative thoraco-abdominal CT in the frontal view is showing the liver protruding in the right thoracic cage (black arrow); (B) the per-operative view upon right thoracotomy with chronic adhesions (black arrowheads) between the lower right lobe, the liver, and the diaphragm; and (C) the per-operative view after reduction of the herniated liver and the diaphragmatic defect.
case_images: fsurg-10-1150241-g002.jpg
case_images: PMC10251140_02_fsurg-10-1150241-g002.jpg
case_images: F2
case_images: A follow-up CT confirmed the diagnosis of right BH: the liver was protruding in the right thoracic cage, and a left pleural effusion was associated (Figure 2). The herniated liver was placed back in the abdomen, and the defect was closed with interrupted non-absorbable sutures (Figure 2).
case_images: PMC10251140_03
case_images: Case 3: (A) Upper midline laparotomy after the reduction of the Bochdalek hernia content. Case 4: (B) The pre-operative thoraco-abdominal CT in the frontal view is showing the "mushroom" shape of the protruding liver and (C) the per-operative view following right thoracotomy, showing the herniated liver before its reduction, presented as a "mushroom" shape.
case_images: fsurg-10-1150241-g003.jpg
case_images: PMC10251140_04_fsurg-10-1150241-g003.jpg
case_images: F3
case_images: A "mushroom" aspect of the liver was found herniated in the thoracic cavity (Figure 3).
case_images: PMC10251140_04
case_images: Case 3: (A) Upper midline laparotomy after the reduction of the Bochdalek hernia content. Case 4: (B) The pre-operative thoraco-abdominal CT in the frontal view is showing the "mushroom" shape of the protruding liver and (C) the per-operative view following right thoracotomy, showing the herniated liver before its reduction, presented as a "mushroom" shape.
case_images: fsurg-10-1150241-g003.jpg
case_images: PMC10251140_04_fsurg-10-1150241-g003.jpg
case_images: F3
case_images: A "mushroom" aspect of the liver was found herniated in the thoracic cavity (Figure 3).