Intraoperative findings confirmed the congenital nature of the hernia and no evidence of a traumatic diaphragmatic rupture. However, surgery was rather urgent since the stomach wall showed signs of hypoperfusion due to the pressure on the wall against the edge of the diaphragm. Additionally, there was evidence of partial splenic herniation intraoperatively. Both organs were repositioned correctly and the hernia was subsequently closed with surgical sutures.

This case nicely demonstrates the prolapsing of organs through a pre-exsisting weak spot, in this case a congenital Bochdalek hernia, due to increased intraabdominal pressure, in this case brought about by physical activity.