Özet:

Introduction: The objective of this study was to investigate the incidence of asymptomatic Bochdalek’s herniae detected incidentally with Multidetector Computed Tomography  and to evaluate the correlation of Bochdalek herniae with obesity and the thickness of the diaphragmatic crus. Materials and Methods: A retrospective screening of the 870 multidetector computed tomography images of thorax and abdomen were performed. The prevalence and localization of Bochdalek herniae were investigated. In patients with Bochdalek herniae, the thickness of the diaphragmatic crus from the border of the defect and the thickness of the subcutaneous fat tissue in the right paramedian area at the level of umbilicus were measured in the axial sections. In addition, the size of the defect and the hernia sac volume were calculated in the same images. Then, the presence of a correlation between defect sizes and hernia sac volumes and the thickness of the diaphragmatic crus and subcutaneous fat tissue were evaluated. Results: 34 BH (3.9%) were detected in 30 patients. Bochdalek herniae was on the left side in 13 patients (43.3%), on the right side in 13 patients (43.3%) and was bilateral in 4 patients (13.3%). The content of the hernia sac consisted of omental fat tissue in 32 patients (94%), of liver in 1 patient (3%) and of colon in 1 patient (3%). The segmental volume of hernia was lower in female patients [153µ;84µ -361µ] thanin male patients  [339µ; 202µ -432.5µ] and the difference was statistically significant (p=0.032). There was no significant correlation between the thickness of the diaphragmatic crus and the subdermal fat tissue and both segmental volume and defect size of hernia (p>0.05). Conclusions: In the present study, the incidence of the incidental Bochdalek herniae detected with Multidetector Computed Tomography is 3.9% and the segmental volume of hernia is significantly lower in females compared with males. Although obesity plays an important role in the pathogenesis of intraabdominal hernia, no significant correlation between the asymptomatic incidental Bochdalek herniae and obesity and thickness of the diaphragmatic crus was detected.

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