Bochdalek hernia is the most common type of congenital diaphragmatic hernia that
occurs predominantly in children, but rarely in adults.1 The Bochdalek hernia
occurs when the abdominal contents herniate into the chest cavity through the
posterolateral portion of the diaphragm. We present a case of a 27-year-old male
who presented with fever and cough. Physical examination disclosed coarse
breathing sounds in the left lower lung field. The chest X-rays showed left-side
pleural effusion, and computed tomography (CT) of the chest revealed massive
herniation of the omentum and partial herniation of the colon into the left pleural
cavity through the posterolateral portion of the left hemidiaphragm. The initial
approach was a limited thoracotomy for the diaphragmatic hernia. Because of
difficulties in complete repair of the diaphragmatic defect, thoracoscopy was used to
assist the procedure. The patient had an uneventful postoperative course.