An Unusual Combination of Diaphragmatic Hernias in a Patient Presenting with the Clinical Features of Restrictive Pulmonary Disease: Report of a Case

Abstract

The combination of a Morgagni hernia and a paraesophageal hernia in adults is very rarely encountered in clinical practice. In fact, to our knowledge, only three cases of this condition, which is probably a coincidental occurrence, have been reported in the medical literature. We discuss the management of a 74-year-old man found to have combined Morgagni and paraesophageal hernia who presented with clinical features of a restrictive pulmonary disease.

Presentation and management of Morgagni hernias in adults: a review of 298 cases

“…Some authors believe that patients with a herniated stomach are more likely to have serious symptoms than those with herniated colon and/or omentum [14]. Occasionally, patients may have a coexisting paraesophageal hernia [15][16][17][18][19]. There are two reported cases of a right Morgagni defect containing both pleural and peritoneal contents [20].…”

Omental Morgagni‐Larrey hernia: An anatomical pictorial essay

“…The size of this type of hernia depends on several factors: the original mass of major omentum, whether the omentum prolapsed completely or partially, and whether there was a compression of the hernial neck with vascular stasis in the prolapsed segment. The size of the sternocostal diaphragmatic defect varies; literature reports vary from 1.5 cm (Schmid et al, 1992) to 8 cm (Ngaage et al, 2001). Very large diaphragmatic defects often cannot be primarily repaired by direct suturing; instead, they require application of synthetic meshes (Kilic et al, 2001).…”

“…Although the abdominal approach and the open repair have the drawbacks of liver retraction and solving the pleural and/or pericardial adhesions, it is necessary to apply it in rare cases of multiple hernias or for complications (Ngaage et al, 2001).…”

A Rare Case of Laparoscopic Repair of Simultaneously Occurring Morgagni and Paraesophageal Hernias

“…2C). 2) The patient was not allowed to eat or drink until she passed gas three days post-operation, at which time she was allowed to resume fluids. The postoperative period was uneventful and the patient was discharged seven days post operation.…”

“…[1][2][3][4][5][6] Within the six case reports, the hernias defect were repaired using laparoscopic techniques only in two cases. 4,5) Herein, we report a case of successful laparoscopic repair of concurring Morgagni and paraesophageal hernias.…”