Rare complications in the late onset of Bushdalek's hernia during pregnancy: a case report.

 

Bouchdelek's hernia is a rare congenital condition characterized by the protrusion of the abdominal organs through a defect in the septum. Although usually diagnosed in infancy or childhood, delayed presentations have been reported in the bulbar stage. og. We present a unique case of delayed manifestation of Bushdalek's hernia during pregnancy, which leads to significant complications. This case highlights the importance of looking for hiatal hernias in pregnant women with unexplained respiratory distress.

 

Status view:

A 32-year-old pregnant woman, gestational 2 para 1, in the 28th week of pregnancy, presented to the emergency department with complaints of Gradually worsen shortness of breath and chest discomfort. The patient had no significant medical history, and her previous pregnancy was unremarkable. The physical examination revealed decreased breathing sounds on the left side of the chest and an increased breathing rate. The oxygen saturation decreased slightly by 92% on the room air. Fetal monitoring showed no signs of distress.

 

After further investigation, a chest x-ray was performed, which revealed a hiatal hernia on the left side with a hernia in the left side. The stomach and intestines are in the left thoracic cavity. This unexpected finding led to an immediate consultation with a thoracic surgeon, and an emergency caesarean section was performed if The baby is delivered safely.

 

During surgery, the hernial contents were reduced, and the diaphragmatic defect was repaired with a retinal implant. His postoperative course was mild, and she recovered well. The baby, who was born prematurely at 28 weeks, required neonatal intensive care but made a full recovery in the meantime. a verse.

 

Discussion :

Bouchdelek's hernia is usually diagnosed early in life due to shortness of breath or gastrointestinal symptoms. Late onset of this condition during pregnancy is extremely rare, with only a few reported cases in the medical literature. bye. Physiological changes in the diaphragm and increased abdominal pressure during pregnancy may contribute to the appearance of this hernia later in life.

 

The clinical manifestations of a Bushdalek hernia during pregnancy can mimic common symptoms associated with pregnancy, such as shortness of breath and abdominal discomfort. digestive system This can lead to delays in diagnosis and potentially life-threatening complications if the hernia is incarcerated or strangulated.

 

Imaging methods, including chest x-ray and computed tomography, are essential for the diagnosis of Bouchdalek's hernia. In our case, the chest x-ray provided a quick diagnosis and facilitated immediate surgical intervention.

 

The management of a Bushdalek hernia during pregnancy presents unique challenges because of the need to balance the well-being of both the mother and the fetus. In cases where the mother's condition is stable, expectant management with close monitoring may be considered until after delivery. . However, if the hernia is causing severe respiratory distress or if complications such as strangulation are suspected, the hernia may be inserted. Surgical intervention is necessary, as was the case with our patient.

 

Conclusion :

We present a rare case of a late-onset Bushdalek hernia during pregnancy, which highlights the importance of considering a diaphragmatic hernia later. d Pregnant women with unexplained respiratory distress. It can perform timely diagnosis, multidisciplinary management involving obstetricians and thoracic surgeons, and appropriate surgical intervention. It has positive results for both mother and fetus. This condition serves as a reminder for physicians to maintain a high index of suspicion for uncommon conditions, even during pregnancy. L, to ensure optimal care for the pregnant patient and her unborn child.