Morgagni-Larrey Hernia: A Possible Cause of Recurrent Lower Respiratory Tract Infections

Abstract

Morgagni-Larrey hernia is an exceedingly rare presentation of congenital diaphragmatic hernia. Despite its rarity, it is associated with significant risk of morbidity and mortality. Herein, we describe a unique case report of an elderly woman who presented with left-sided chest pain, dyspnea, and chronic history of recurrent respiratory tract infections. On the basis of her medical history, general physical examination and imaging studies, she was operated for a presumptive diagnosis of thymolipoma. However, the intra-operative findings revealed that it was an unusual variant of a diaphragmatic hernia and the hernia sac appeared through the retrosternal foramen of Morgagni. Hence we concluded that it was a Morgagni-Larrey hernia compressing the lungs and heart. Consequently, the hernia was reduced and the defect was repaired. During the postoperative period, the patient had an uneventful recovery. To conclude, the possibility of a Morgagni-Larrey hernia should be strongly considered while evaluating a patient with recurrent chest infections, dyspnea, and vague chest pain.

Periappendiceal fat-stranding models for discriminating between complicated and uncomplicated acute appendicitis: a diagnostic and validation study

“…Imaoka et al [ 28 ] Temp ≥ 37.4 °C (1) 1/3 84.9% (77.4–94.5%) 68.6% (63.7–73.6%) 0.800 (0.745–0.854) CRP ≥ 4.7 (1) Periappendiceal fluid Yes (1) 3. Khan et al [ 16 ] Age 40–59 years (1) 2/4 73.4% (62.6–84.3%) 58.8% (53.6–61.1%) 0.694 (0.630–0.759) ≥ 60 years (2) Duration of symptoms ≥ 2 days (1) Appendicolith Yes (1) 4. TH Kim et al [ 33 ] Appendiceal diameter > 10 mm (1) 3/4 56.3% (44.1–68.4%) 86.1% (82.4–89.8%) 0.777 (0.718–0.835) Ascites Yes (1) Fat stranding Yes (1) CRP > 5.0 mg/dL (1) …”

“…We revised the cutoff of the CRP level to ≥ 3 mg/dL because a CRP level of 0–3 mg/dL is used as the reference limit in our and most other hospital laboratories. Furthermore, Khan et al [ 16 ] used two continuous variables, namely age and abdominal pain duration, and one discrete variable, namely appendicolith (present or absent), in their model. We used the cutoff values of 40 and 60 years for age and ≥ 2 days for the abdominal pain duration.…”

“…However, a missed diagnosis of appendiceal perforation can lead to complications such as abscess formation and purulent peritonitis [ 14 , 15 ]. The rupture rate of acute appendicitis is approximately 20–34% [ 16 – 19 ]. Patients who wish to avoid appendectomy must be aware of a recurrent risk of approximately 39% after 5 years.…”

“…To the best of our knowledge, a total of eight models for predicting the risk of perforated appendicitis have been developed by Bröker et al [ 32 ], Imaoka et al [ 28 ], Khan et al [ 16 ], Kim et al [ 33 ], Kang et al [ 34 ], Atema et al [ 35 ], Avanesov et al [ 36 ], and Kim et al [ 37 ]. However, the number and types of factors included for predicting complicated appendicitis differ considerably among these eight models.…”

Changes in Sexual Functions and Alexithymia Levels of Patients with Type 2 Diabetes During the COVID-19 Pandemic

“…In a study conducted with 4872 participants above the age of 18 in Wuhan, it was found that the rate of depression was 48.3%, the rate of anxiety was 22.6%, the rate of depression and anxiety was 19.4% during the COVID-19 outbreak [ 54 ]. In studies conducted with patients with diabetes, it was found that anxiety and depression were observed at a high rate during the COVID-19 pandemic [ 55 , 56 ]. Similar to the literature, in this study, anxiety, and depression symptoms were observed with a high rate in participants.…”