We present the case of a 53-year-old woman with Marfan's syndrome, who suffered abdominal pain, nausea and vomiting. Laboratory test showed only elevation of leucocytosis (13,450 cells). Chest radiograph revealed the existence of a large air bubble at midthoracic level. Computed tomography (Figs. 1 and 2) revealed the existence of a left diaphragmatic defect at the anterior midline, with partial gastric herniation through it and conditioning a high-grade gastric obstruction. Almost the entire colon and multiple ileal segments were also at intrathoracic position. Following the introduction of a nasogastric tube suction the patient improved significantly, so a scheduled laparoscopic surgery was performed: reduction of viscera into the abdominal cavity and repairing of the left anterior hernial orifice with the placement of prostheses.
DISCUSSIONCongenital diaphragmatic hernia is a rare condition. The so-called hernia of Morgagni (anterior location) is about 3-5% of the diaphragmatic hernias, being the right side the most frequently affected, as the pericardium protects the left side (1).
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