Congenital herniation through the foramen Morgagni — clinical presentation, diagnosis and treatment in pediatric population

Abstract

<jats:title>Abstract</jats:title><jats:p>Congenital Morgagni hernia is a rare entity, accounting for less than 1,5% of all types of congenital diaphragmatic hernias. The majority of Morgagni hernias are diagnosed late because patients can be asymptomatic or present with non-specific respiratory and gastrointestinal symptoms and signs. The medical records of all patients diagnosed with CMH and treated in our hospital were retrospectively reviewed for age at diagnosis, sex, site of hernia, clinical symptoms, associated anomalies, operative findings and treatment. Over a 20-year period, 5 cases with CMH diagnoses were hospitalized and operated. The age of diagnosis ranged from nine months to 11 years. Male to female ratio was 3:2. Associated anomalies were seen in 2 patients (40%). Most patients had transabdominal operations. There were no complications in the postoperative period. Morgagni hernia is a rare condition. The rarity is due to the nonspecific presentation of symptoms, which contributes to a delay in diagnosis. We advocate surgical repair even in asymptomatic patients, because of the risk of strangulation. There is a low rate of complications.</jats:p>

Bilateral Morgagni hernia in a donkey

“…In none of the cases described in the literature, the hernial sac was resected, and only one horse had fluid accumulation in the dead space left after resolution of the hernia, without any significal clinical sequelae (Pauwels et al 2007). In humans, surgical removal of the hernial sac is controversial and there is no consensus about the benefit of this procedure (Andelka et al 2011). Some authors recommend sac excision because it may decrease the chance for symptomatic fluid collection and reduce recurrence rate, because the sac itself can act as a lead point for recurrent herniation.…”

Turner syndrome and morgagni hernia in newborn: A case report

“…Therefore, a period of medical stabilization and delay in repair was proposed in an attempt to improve the general condition of the newborn with HDC. The survival rate of newborns with CDH ranges from 60 to 90% through the use of physiological treatment strategies including gentle ventilation techniques, high-frequency ventilation, cardiovascular pharmacological support, and extracorporeal membrane oxygenation (ECMO) with gradual improvement in survival 5,6 .…”

“…Chest radiography is usually the study in which the defect is identified during the neonatal period, where a structure is identified behind the cardiac silhouette and the lateral projection allows this structure to be located in the retrosternal area. There may be other alterations or syndromes associated with Morgagni's diaphragmatic defect, among which are intestinal malrotation, esophageal atresia, omphalocele, trisomy 21, 18, and 13, Beckwith-Wiedemann syndrome, and Goldenhar syndrome 5,6 .…”

Acute Respiratory Failure, Ischemic Modifications on Electrocardiogram: Alternative Etiology—A Case of Morgagni Hernia

“…The Morgagni hernia accounts for approximately 1.5% of all congenital diaphragm hernia (CDH) cases [2,3]. In most cases, Morgagni hernias are diagnosed late due to the fact that patients can be asymptomatic or can display vague gastrointestinal and respiratory signs and symptoms.…”