Bochdalek Hernia with Extralobar Pulmonary Sequestration in an Adult: A Case Report

成人Bochdalek橫隔膜疝氣合併肺葉外游離肺：病例報告

黃丞正(Chen-Cheng Huang) ； 吳杰亮(Chieh-Liang Wu) ； 楊啟順(Chii-Shuenn Yen) ； 許正園(Jeng-Yuan Hsu) ； 夏君毅(Jiun-Yi Hsia)

《胸腔醫學》 23卷4期 (2008/08) Pp. 284-289

https://doi.org/10.29806/TM.200808.0008

摘要

這裡我們報告一例成人Bochdalek橫隔膜疝氣合併疝氣囊內肺葉外游離肺在臨床上是極少見的情形。一位22歲男性意外發現左下肺野有囊狀病灶。胸部電腦斷層顯示在左側橫隔膜後方內側有個橫隔膜疝氣（Bochdalek橫隔膜疝氣）。手術發現左側腎臟和大腸疝脫至胸部，而病理檢查報告除了Bochdalek橫隔膜疝氣外，在疝氣囊內有肺葉外游離肺。根據病理發現及胚胎發展，我們推測也許肺葉外游離肺在胚胎發育時佔據了肋腹膜間的通道且阻礙它完全的關閉，而形成橫隔膜疝氣。

關鍵字

Bochdalek橫隔膜疝氣 ； 肺葉外游離肺

並列摘要

We report a case of Bochdalek hernia with extralobar pulmonary sequestration in the hernia sac in an adult, which is extremely rare clinically. An incidental finding of a cystic lesion in the left lower lung field was made in a 22-year-old man. Computed tomography of the chest disclosed a diaphragmatic hernia in the the posterior-medial part of the left hemidiaphragm (Bochdalek hernia). The surgical finding was left kidney and colon herniation into the chest. However, pathologic examination demonstrated extra-lobar pulmonary sequestration in the hernia sac, in addition to the Bochdalek hernia. Based on the pathological findings and the sequence of embryonic development, we speculated that the sequestrated extrapulmonary lung, which occurred in the development of the fetus, might have occupied the site of the pleuroperitoneal canal and hindered its complete closure, hence forming the diaphragmatic hernia.

並列關鍵字

Bochdalek hernia ； extralobar pulmonary sequestration