Late presentation of Bochdalek hernia in children - experience at a single centre.

Background: The aim of this study was to present our experience with late presentation Bochdalek hernia (BH), focussing on clinical presentation diagnostic and therapeutic approaches, and their outcomes.

Methods: Patients with late presenting BH 1 month of age between 1983 and 2022 were studied. We retrospectively collected and analysed the following data: age, sex, side of herniation, presenting symptoms and signs, associated anomalies, radiographic findings, intraoperative findings, postoperative course, complications, and mortality.

Results: Of 175 diaphragmatic hernias 46 (26%) were late presenting BH. Fifty-seven per cent (26/46) were males. Laparotomy was performed in 85% (39/46) of the patients, and a laparoscopy or thoracoscopy was performed in 15% (7/46). The mean hospital stay was 7.6 days, and the mean surgery time was 131 minutes. When the two groups were compared, the duration of surgery and hospitalisation was significantly shorter in the minimally invasive surgery (MIS) group (p < 0.05).

Conclusion: The clinical characteristics of late presenting BH are variable, either acute or chronic. A laparoscopic or thoracoscopic approach in selected patients is feasible.