Laparoscopic repair of an excessive Morgagni hernia in an adult presenting as upside-down stomach

Sahsamanis, Georgios; Terzoglou, Alexandra; Theodoridis, Charalampos; Kiakou, Maria; Mitsopoulos, Georgios; Deverakis, Titos; Dimitrakopoulos, Georgios

doi:10.1016/j.ijscr.2017.11.014

Cited by 6 publications

(3 citation statements)

References 11 publications

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“…CT scan is obtained for a specific diagnoses of Morgagni hernia in order to strategize your surgical approach. Minimally invasive laparoscopic techniques have become a popular option in the 21 st century due to reduced intraoperative morbidity and quicker recovery rates [9]. Our case was unique in that the novel use of a sleeve of composite mesh was used as a bolster for the Ethibond suture as opposed to felt pledgets so the suture would not pull through the diaphragm.…”

Section: Discussionmentioning

confidence: 99%

Innovative use of mesh bolster for adult Morgagni hernia repair

Azar

Robertson

et al. 2019

Journal of Surgical Case Reports

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Morgagni hernia is a rare type of congenital diaphragmatic hernia caused by lack of fusion of the pleuroperitoneal membrane anteriorly leading to a defect in the foramen of Morgagni. These are rare hernias and typically present early in life. Those that do not get repaired during infancy or adolescence often present later in life with variable symptoms including obstruction, incarceration, strangulation, pulmonary symptoms, chest pain, etc. Herein we present an adult case that was found incidentally after a screening computerized tomography (CT) chest scan was done for history of smoking. There are two unique aspects to this case: first, given the large size of her hernia, her only complaint was mild shortness of breath and second, the innovative use of mesh as a suture bolster.

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Section: Discussionmentioning

confidence: 99%

Innovative use of mesh bolster for adult Morgagni hernia repair

Azar

Robertson

et al. 2019

Journal of Surgical Case Reports

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“…The patient of the case did not present any risk factor for the increase of this pressure, which reiterates its congenital origin. 8,14,15 Due to cardiorespiratory discomfort and gastrointestinal manifestations, diagnosis and treatment in childhood become more prevalent, making the diagnosis in adult life uncommon, with reports of a higher incidence in females in more than 50% of cases and the mean of age of the diagnosis of 53 years. The clinical picture varies according to the size of the defect and herniated organ, and, unlike the child, the symptoms are chronic, and may present with nausea, vomiting, anorexia, abdominal pain, chest pain, dyspnea, dyspepsia or even asymptomaticthe absence of symptoms due to the fact that the organs are commonly lined by the parietal peritoneum of the hernia sac.…”

Section: Discussionmentioning

confidence: 99%

Morgagni Hernia as a Differential Diagnosis in an Adult: A Case Report

Nóbrega

Araújo

Araújo³

et al. 2019

AIMJ

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Morgagni Hernia (MH) is a defect between the transverse septum and the sternum, failing the fusion of the sternal and costal parts of the muscle, representing 3 to 4% of the hernia’s diaphragmatic lesions of congenital origin. It is present in 90% of the cases on the right side, 8% on the left side and 2% on the bilateral side. The aim of this article is to report a case on late presentation of MH and to emphasize the importance of this pathology to be analyzed with differential diagnosis in patients with respiratory symptoms. The subject is a patient, male, 62 years old, truck driver, married, with history of dyspnea on medium exertion and mild chest discomfort from 2 years. After 1 year of these symptoms, he evolved with major dyspnea on minor exertion, intense chest pain, without improvement with analgesics or with body positions, making it difficult to perform his usual activities as work and leisure. Multislice Computed Tomography of the Thorax, which showed: diaphragmatic hernia in the left hemithorax, with a ring/diaphragmatic fault located in the anterior and medial pericardial third, and an intrathoracic hernia, notably in the base and middle third in the anterior, lateral and posterior regions, with contents mesenteric and intestinal. The patient underwent thoracotomy in the sixth left intercostal space. A large amount of omentum, transverse colon, stomach, pulmonary atelectasis and small pleural effusion were found. The omentum resection was performed, located hernial ring in the antero-medial portion of the diaphragm, reduction of the hernia, placement of the Malex mesh and apposition of two anterior and posterior thoracic drains. Reports of patients initially diagnosed with pneumonia or treated as chronic dyspeptic, who progressed to intestinal necrosis, respiratory failure or other complications due to late diagnosis, emphasize the relevance of the knowledge of MH as a differential diagnosis of respiratory and gastrointestinal symptoms.

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“…The only difficulty in sac resection was on the anterior side adjacent to the pericardium and the organ within, and it can be avoided by choosing a trans-thoracic approach. 15,17,19 Conclusion A laparoscopic approach referred to the method of choice in the management of adult diaphragmatic hernia of Morgagni. Unnecessary resection of hernial sac and tension free defect closure should be of one consideration.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Approach in Correction of Adult Diaphragmatic Morgagni Hernia

Mazni

Prabowo

2018

NRJS

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Introduction. Adult diaphragmatic hernia of Morgagni is a very rare congenital anomaly. Therefore, to date there is no standard surgical techniques used in the management. Thus, a systematic review aimed to find the highest evidence in the management. Method. A systematic review conducted in accordance with PRISMA. Literature search proceeded on PubMed and ScienceDirect using keywords "diaphragmatic hernia of Morgagni in adult", and "treatment". These articles were reviewed and appraised for the study design used, enrolled samples, validation of results, etc. to find out the level of evidence. The analysis was focused on length of stay, the recurrence, and complications.Results. There were 15 articles reviewed. The transabdominal approach provides better exposure, short length of stays, and low complications. Laparoscopic has been used widely and replaces open surgery. The defect closure using mesh is indicated in large defect of ≥20 cm 2 . The hernial sac is unnecessary to resect, with no complication such as seroma or recurrence. Conclusion. A laparoscopic approach referred to the method of choice in the management of adult diaphragmatic hernia of Morgagni. Unnecessary resection of hernial sac and tension free defect closure should be of one consideration.

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Laparoscopic repair of an excessive Morgagni hernia in an adult presenting as upside-down stomach

Cited by 6 publications

References 11 publications

Innovative use of mesh bolster for adult Morgagni hernia repair

Innovative use of mesh bolster for adult Morgagni hernia repair

Morgagni Hernia as a Differential Diagnosis in an Adult: A Case Report

Laparoscopic Approach in Correction of Adult Diaphragmatic Morgagni Hernia

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