Vincent Bochdalek
Vincenz Alexander Bohdalek (1801–1883) was a Czech anatomist and pathologist
Bohemian anatomist whose meticulous dissections shaped understanding of both the thoracoabdominal wall and the central nervous system. Educated at the Charles University in Prague, he rose to the chair of anatomy in 1833 and became one of the most respected teachers of his era, later serving as dean and rector of the university. His career spanned more than four decades of scholarship and instruction, with lasting influence on surgical and neuroanatomical practice.
Bochdalek is best remembered for his description of congenital posterolateral diaphragmatic defects in 1848, later termed Bochdalek’s hernia. This rare but serious condition remains the most common form of congenital diaphragmatic hernia in infants and continues to carry his name in clinical practice. He also identified the delicate frond-like projections of the fourth ventricular choroid plexus that extend through the foramina of Luschka, a benign anatomical variant termed Bochdalek’s flower basket.
Although his contributions span disciplines from abdominal wall anatomy to the intricacies of the posterior fossa, Bochdalek’s legacy is anchored in the clarity of his descriptions and the precision of his dissections. His eponyms endure not only in textbooks but in modern surgical and radiological vocabulary, a reflection of the enduring utility of his 19th-century observations.
Biographical Timeline
- 1801 – Born February 11 in Skřipov, Austrian Silesia (now Czech Republic).
- 1819–1825 – Studied medicine at the Charles University in Prague; graduated MD in 1825.
- 1825–1833 – Assistant in anatomy and pathology at Prague; published early anatomical works.
- 1833 – Appointed Professor of Anatomy at Charles University, Prague; Thesis: Anleitung zur praktischen Zergliederung des menschlichen Gehirnes
- 1841 – Published Anatomische Beobachtungen und Bemerkungen, with studies of the cerebellum and posterior fossa.
- 1848 – Described congenital diaphragmatic hernia (later termed Bochdalek’s hernia) in Prager Vierteljahrsschrift für die praktische Heilkunde.
- 1850s–1860s – Reported anatomical features of the choroid plexus (Bochdalek’s flower basket) and other neuroanatomical observations.
- 1861–1862 – Served as Dean of the Prague Medical Faculty.
- 1869 – Elected Rector of Charles University.
- 1883 – Died on February 3 in Litoměřice, Bohemia (now Czech Republic)
Medical Eponyms
Bochdalek foramen (lumbocostal triangle, foramen Bochdaleki) (1848)
Bochdalek’s posterior diaphragmatic gap (hintere Zwerchfelllücke) is a triangular, membranous area between the outer lumbar crus, last costal digitations, and the 12th rib. It is closed by pleura and a tendinous sheet from the fascia iliaca and often larger on the left. Its low resistance predisposes to congenital posterolateral diaphragmatic hernia. Also known as trigonum lumbocostale or foramen Bochdaleki
Original
English
Diese Lücke … welche ich die hintere Zwerchfelllücke nennen will, befindet sich zwischen dem äußeren oder dritten Schenkel des Lendenteils des Zwerchfells, der letzten fleischigen Zacke seines Rippenteils, und der letzten falschen Rippe. Sie hat meist die Gestalt eines Dreieckesder zwischen diesen Rändern eingeschlossene Raum
… ist mittelst eines Hautblattes verschlossen, welches aus zwei Schichten besteht. Die obere Schicht rührt vom Brustfelle her … die untere Schichte ist sehnicht, eine Fortsetzung der Fascia iliaca …Gewöhnlich ist die der linken Seite etwas umfangreicher als die der rechten. – Bochdalek 1848
This gap, which I propose to call the posterior diaphragmatic gap, lies between the outer (third) crus of the lumbar part of the diaphragm, the last muscular digitations of its costal part, and the last false rib. It is usually triangular in shape…
The space enclosed by these borders is closed by a membranous sheet composed of two layers: the upper derives from the pleura, the lower is tendinous, a continuation of the fascia iliaca…Usually the gap on the left side is somewhat larger than that on the right – Bochdalek 1848
Bochdalek hernia (1848)
A Bochdalek hernia is a congenital, posterolateral diaphragmatic defect that allows abdominal viscera to herniate into the thorax, compressing the developing lung and leading to pulmonary hypoplasia and neonatal respiratory compromise. The defect reflects failed closure of the pleuroperitoneal canal during embryogenesis.
Classically presents in the newborn with respiratory distress. In adults it is an uncommon and often incidental CT finding. In a large CT series of ≥13,000 scans, incidental BH prevalence was found to be 0.17%, mostly right-sided and usually involved fat/omentum only sacs.
Imaging: Plain films may mislead. Thin-section CT with multiplanar reformats have a reported sensitivity of 78% (left) and 50% (right).
Management: Neonates require early stabilisation (from gentle ventilation to HFOV/ECMO in severe cases) and delayed repair when optimised. Adults: definitive surgical repair to prevent obstruction/volvulus. Good outcomes with minimally invasive approaches such as laparoscopic/thoracoscopic/robotic
Historical timeline
1848 – Bochdalek provided the first description of a posterior diaphragmatic defect (Bochdalek foramen) with herniation causing neonatal death. He proposed a mechanism for herniation and went on to predict that surgery would be able to repair the defect in the future.
Original
English
Bei der … Tatsache, daß ein rein häutiges Gebilde weniger widerstandsfähig ist … geschieht es … daß die häutige Lücke dem Andrange der Baucheingeweide geringeren Widerstand … leistet; deshalb wird … [sie] ausgedehnt … in den Brusthöhlenraum erhoben und so zu einem förmlichen Bruchsack gestaltet.
Die Veranlassung … ist … in der embryonalen umgekehrten Lage des Körpers … und dem Anpressen der Oberschenkel an den Unterleib … wodurch [die Eingeweide] vorzüglich gegen den hinteren Teil des Zwerchfells … getrieben werden.
…es vielleicht doch nicht unmöglich wäre, bei einem Bruche durch die hintere Zwerchfelllücke, einen Einschnitt dicht unter dem unteren Rande der letzten Rippe … zu wagen … an die Bruchpforte zu gelangen, und die Reposition … zu versuchen. – Bochdalek 1848
Because a purely membranous structure is less resistant, this membranous gap offers reduced opposition to the pressure of the abdominal viscera; it is therefore stretched, protrudes into the thoracic cavity, and becomes a true hernial sac.
The precipitating circumstances lie in the inverted fetal posture … with the thighs pressed against the abdomen, driving the viscera especially against the posterior diaphragm in the region of the gap.…it might not be impossible, in a hernia through the posterior diaphragmatic gap, to make an incision just below the lower edge of the last rib to reach the hernial orifice and attempt reduction – Bochdalek 1848
1946 – Robert E. Gross (1905–1988) performed the first successful neonatal repair of a congenital posterolateral (Bochdalek-type) diaphragmatic hernia; one case operated at 22 hours of age (left posterior defect). Gross also emphasized the posterior/posterolateral predominance and advocated a transabdominal approach in early life.
Bochdalek’s flower basket (Blumenkörbchen Bochdaleks)
Tthe tufted protrusions of the choroid plexus that extend through the foramina of Luschka into the cerebellopontine angle cistern. These vascular, frond-like expansions were described in detail by Bochdalek during his neuroanatomical studies of the fourth ventricle.
The appearance of these plexus protrusions inspired the metaphor “flower basket.” Blumenkörbchen Bochdaleks is a relatively common finding, with the calcified flower basket appearing in 38% of patients >51 years in one CT study [Horsburgh, 2012]
A benign normal anatomical variant, the protrusion of calcified choroid tissue in the fourth ventricle can mimic pathology on CT or MRI such as subarachnoid haemorrhage or cerebellopontine mass.
[Radiopaedia: Case 1, Case 2, Case 3]
Controversies
Vincentz Alexander Bohdalek born on February 11, 1801 at Skřipov
Name and spelling: Bochdalek’s given name appears in records as “Vincentz” (consistent with Habsburg-era Bohemia). Later sources anglicised this to “Vincent”, but he himself signed “Vincenz” in correspondence and publications.
Surname: In the Czech Republic public register of births, his surname appears as “Bohdalek”, the German spelling. In later years, he insisted on using the Czech spelling “Bochdalek”, as the Germanised “Bohdalek” created a pronunciation he disagreed with.
Date and Place of birth: Bochdalek’s birth date of birth is variably recorded as either February 6, 1801 or February 11, 1801 at either Litoměřice or Skřipov. Parish registers support being born on February 11, 1801 at Skřipov near Opava in the then Austrian Silesia
Major Publications
- Bochdalek VA. Anleitung zur praktischen Zergliederung des menschlichen Gehirnes, nebst einer anatomischen Beschreibung desselben; mit besonderer Rucksicht auf das kleine Gehirn. Prag: Gottlieb Haase Sohne; 1833
- Bochdalek VA. Neue Untersuchungen und genaue Würdigung der Nerven des Ober- und Unterkiefers. Medizinische Jahrbücher des kaiserlich-königlichen österreichischen Staates, 1836; 19: 223-240.
- Bochdalek VA. Einige Betrachtungen über die Entstehung des angeborenen Zwerchfellbruches als Beitrag zur pathologischen Anatomie der Hernien. Vierteljahrschrift für die praktische Heilkunde. (Prag) 1848; 19: 89 [Bochdalek hernia]
- Bochdalek VA. Ueber das Verhalten des Mediastinums zur vorderen Brustwand, zu den Lungen, zum Herzen und Herzbeutel. Vierteljahrschrift für die praktische Heilkunde 1860; 65 :3–54
- Bochdalek VA. Beitrag zu den anomalen Muskeln in der Augenhöhle. 1905
References
Biography
- Zprávy. Časopis lékařů českých 1883; 22: 92-93
- Wondrák E. Ceský anatom a patolog V.A. Bochdalek–100 let od smrti [The Czech anatomist and pathologist V.A. Bochdalek–100 years since his death]. Cas Lek Cesk. 1983 Oct 28; 122(43): 1334-7.
- Haller JA Jr. Professor Bochdalek and his hernia: then and now. Prog Pediatr Surg. 1986;20:252-5.
- Loukas M, El-Sedfy A, Tubbs RS, Gribben WB, Shoja MM, Cermakova A. Vincent Alexander Bochdalek (1801–1883). World J Surg. 2008; 32(10): 2324-6.
- Kachlik D, Cech P. Vincenz Alexander Bochdalek (1801-83). J Med Biogr. 2011 Feb;19(1):38-43
- Bibliography. Bochdalek, Vinzenz Alex. WorldCat Identities
Eponymous terms
- Gross RE. Congenital hernia of the diaphragm. Am J Dis Child. 1946 Jun;71:579-92.
- Haller JA. Professor Bochdalek and His Hernia: Then and Now. In: Rickham, P.P. (eds) Historical Aspects of Pediatric Surgery. Progress in Pediatric Surgery, 1956; 20: 252-255
- Mullins ME, Stein J, Saini SS, Mueller PR. Prevalence of incidental Bochdalek’s hernia in a large adult population. AJR Am J Roentgenol. 2001 Aug;177(2):363-6
- Cech P, Kachlik D. 175th anniversary of Bochdalek’s inaugural dissertation. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2009 Mar;153(1):83-6.
- Brown SR, Horton JD, Trivette E, Hofmann LJ, Johnson JM. Bochdalek hernia in the adult: demographics, presentation, and surgical management. Hernia. 2011 Feb;15(1):23-30.
- Horsburgh A, Kirollos RW, Massoud TF. Bochdalek’s flower basket: applied neuroimaging morphometry and variants of choroid plexus in the cerebellopontine angles. Neuroradiology. 2012 Dec;54(12):1341-6.
- Berger M, Muensterer O, Harmon CM. Tales from previous times: important eponyms in pediatric surgery. Pediatr Surg Int. 2014; 30(1): 1-10
- Buttner R, Lee J. De-eponymising anatomical terminology. 2020
Eponym
the person behind the name
