Anesthetic management of Morgagni hernia repair in an elderly woman

Nama, Rajnish K; Butala, Bina P; Shah, Veena R; Patel, Hiren

doi:10.4103/0259-1162.157467

Cited by 8 publications

(7 citation statements)

References 12 publications

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“…Of the 171 cases identified from 76 articles in the past decade (Tables 1-3), 13-81 the majority of reported MH repairs were attempted through minimally invasive techniques (31), including laparoscopy (30) and thoracoscopy (1), followed by open abdominal approaches (31) exclusively attempted via laparotomy (31), and finally...…”

Section: Resultsmentioning

confidence: 99%

Morgagni Hernia Repair: A Review

et al. 2018

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Anteromedial subcostosternal defects, also known as a diaphragmatic hernia of Morgagni (MH), allow potentially life-threatening herniation of the abdominal organs into the thorax. Constituting only a small fraction of all types of congenital diaphragmatic hernias, correct diagnosis of MH is often delayed, owing in large part to nonspecific associated respiratory and gastrointestinal complaints. Once identified, the primary management for both symptomatic and incidentally discovered asymptomatic cases of MH are surgical correction because the herniated contents present increasing risk for strangulation. Various thoracic and abdominal surgical approaches have been described without a clear consensus on preference for operative repair technique. In this article, the literature regarding management of MH within the past decade is reviewed, and an illustrative case of laparoscopic repair of a MH with novel reinforcement using a Falciform ligament onlay flap is presented.

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Section: Resultsmentioning

confidence: 99%

Morgagni Hernia Repair: A Review

et al. 2018

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“…Three common sites of herniation are (A) Posterolaterally through the foramen of Bochdalek (78%-90%) (B) esophageal hiatus (14%-24%) (C) retrosternally through the foramen of Morgagni (1.5%-6%). 1 Only 79 cases in a study of 3098 cases of CDH presented with late onset. 1 It emphasizes the rarity of our case as our patient was 70-year-old at the time of presentation.…”

Section: Discussionmentioning

confidence: 99%

“…1 Only 79 cases in a study of 3098 cases of CDH presented with late onset. 1 It emphasizes the rarity of our case as our patient was 70-year-old at the time of presentation.…”

Section: Discussionmentioning

confidence: 99%

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The usefulness of the transesophageal Doppler in the anesthetic management of Morgagni hernia repair - A case report

Babo¹,

Monteiro²,

Santos³

et al. 2021

APIC

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Morgagni hernia in adults is a rare condition and is associated with complications such as recurrent chest infections, respiratory failure and cardiac tamponade. Its correction represents an anesthetic challenge. Intraoperative esophageal Doppler provides important information in real time about the patient’s cardiac function and vascular filling, aiding in decision making by the anesthesiologist. We report a case of a 70–year–old woman, ASA Physical Status–III, and presented with chest pain, dyspnea and hypoxemia. Her chest x-ray revealed opacification of 2/3 of the left hemithorax and 1/2 of the right. Computed tomography confirmed a bilateral Morgagni hernia. The patient underwent immediate corrective surgery. Intraoperative cardiovascular function was monitored with esophageal Doppler. Compression and decompression of thoracic structures produces enormous hemodynamic and respiratory impact. After herniated contents removal it showed an increase in systolic volume and cardiac index and a correction of flow time. Transient arterial hypotension was verified, requiring fluid therapy and vasopressor support. Diaphragmatic defect was corrected and general hemodynamic stabilization was achieved. Patient was discharged asymptomatic. The esophageal Doppler was important in this case because it allowed us to measure fundamental hemodynamic variables in real time, such as cardiac index or systolic volume, and to subsequently act accordingly. Key words: Esophageal; Doppler; Morgagni hernia; Anesthesia Citation: Babo NM, Monteiro MT, Santos AB, Carreira CR. The usefulness of the transesophageal Doppler in the anesthetic management of Morgagni hernia repair - A case report. Anaesth pain intensive care 2021;25(2):206-211. DOI: 10.35975/apic.v25i2.1467 Received: 19 November 2020, Reviewed: 22 December 2020, Accepted: 12 January 2021

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“…Until 1980 only the symptomatic forms were operated on. Anesthetic problems occur in the case of children and the elderly (17,18).…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Management in Morgagni Hernia - Short Series and Review of Literature

Târcoveanu¹,

Georgescu²,

Vasilescu³

et al. 2018

chr

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Morgagni hernia occurs after a congenital retrosternal diaphragmatic defect; it is a rare form of diaphragmatic hernia (1-3% of cases). In general, this pathology is diagnosed in children; in adults it is frequently discovered in emergency or incidentally. We prospectively evaluated a series of 8 patients admitted to First Surgical Clinic, St. Spiridon Hospital, Iasi during the period 2011-2017. Out of 8 patients, 6 were operated on, one patient refusing surgery (followed periodically); the patient who was 91 years old had serious associated diseases that made surgery contraindicated. Symptomatology was nonspecific: in 5 cases Morgagni hernia was discovered during the exploration of an associated pathology, either with cardiopulmonary symptoms of dyspnea or palpitations. In 2 cases, the clinical aspect suggested an occlusive syndrome (the herniated organ is usually the transverse colon). The laparoscopic approach was used in all cases: two conversions were recorded due to the tight adherences of the herniated viscera (gastric, colon, epiplon). In 4 cases, the surgical cure of hernia was performed by suture and in 2 cases with prosthesis: dual mesh in one case and polypropylene mesh in another case. We did not register morbidity and the mean postoperative stay was 4 days (range 2-6 days). Hernia Morgagni betrays a rare pathology. The most common is asymptomatic but in complicated cases it is a cause of acute surgical abdomen. Surgical treatment is indicated even for asymptomatic cases due to serious complications Morgagni hernia may develop. The laparoscopic approach is ideal, as reduction of viscera in the abdomen is easy and the defect will be repaired by suturing or using a prosthesis, depending on its size.

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Anesthetic management of Morgagni hernia repair in an elderly woman

Cited by 8 publications

References 12 publications

Morgagni Hernia Repair: A Review

Morgagni Hernia Repair: A Review

The usefulness of the transesophageal Doppler in the anesthetic management of Morgagni hernia repair - A case report

Laparoscopic Management in Morgagni Hernia - Short Series and Review of Literature

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