ABSTRACT

Morgagni hernia is a rare congenital disorder, which is usually asymptomatic, but may cause respiratory or gastrointestinal symptoms. Material and methods: We reviewed the clinical findings of 8 patients with a Morgagni hernia, diagnosed and treated at our institution between 1991 and 2007. Results: 4 patients were asymptomatic and the Morgagni hernia was an intraoperative finding during a surgery for other reason, 2 complained of dyspnea and 2 presented bowel obstruction symptoms. Preoperative diagnostic tests performed were abdominal X-ray in 3 patients, revealing a mass containing solid areas and fluid levels at the cardiophrenic angle, and CT scan in 2.6 patients underwent elective surgery and the 2 cases with bowel obstruction, emergency surgery. Abdominal approach was performed in all patients; in 7 a formal middle laparotomy was performed and 1 case was laparoscopically repaired. The herniated organs were transverse colon, greater omentum and stomach. The hernia was located on the righten side in 7 cases and on the leften in 1. Prosthetic mesh was used in only 1 patient. Two patients presented surgical complications: a wound infection and an intra-abdominal abscess. Conclusion: Surgical repair of Morgagni hernia is indicated even in asymptomatic cases to prevent further complications, such as bowel obstructions or respiratory symptoms.

KEYWORDS

Morgagni hernia, diaphragmatic hernia, laparoscopic surgery.

REFERENCES

1. Kurkcuoglu IC, Eroglu A, Karaoglanoglu N, Turkyilmaz A, Tekinbas C, Basoglu A. Diagnosis and surgical treatment of Morgagni hernia: Report of 3 cases. Surg Today 2003; 33: 525-8.

2. Hussong RL, Landreneau RJ, Cole FH. Diagnosis and repair of a Morgagni hernia with video-assisted thoracic surgery. Ann Thorac Surg 1997; 63: 1474-5.

3. Federico JA, Ponn RB. Foramen of Morgagni hernia. In: Shields TW, LoCicero III J, Pon RB. General thoracic surgery. 5th ed. Philadelphia: Lippincott Williams and Wilkins; 2000: 647-60.

4. Stimec BV, Milisavljevic M, Malikovic A, Fasel JH. Omental Morgagni-Larrey hernia: an anatomical pictorial essay. Clin Anat 2008; [Epub ahead of print].

5. Valases C, Sills C. Case report: anterior diaphragmatic hernia (hernia of Morgagni). N Engl J Med 1998; 85: 603-5.

6. Horton JD, Hofmann LJ, Hetz SP. Presentation and management of Morgagni hernias in adults: a review of 298 cases. Surg Endosc 2008; 22: 1413-20.

7. Newman L, Eubanks S, Bridges WM, Lucas G. Laparoscopic diagnosis and treatment of Morgagni hernia. Surg Laparosc Endosc 1995; 5: 27-31.

8. Pironi D, Palazzini G, Arcieri S, Candioli S, Manigrasso A, Panarese A, et al. Laparoscopic diagnosis and treatment of diaphragmatic Morgagni hernia. Case report and review of the literature. Ann Ital Chir 2008; 79: 29-36.

9. Durak E, Gur S, Cokmez A, Atahan K, Zahtz E, Tarcan E. Laparoscopic repair of Morgagni hernia. Hernia 2007; 11(3): 265-70.

10. Donati M. Surgical treatment of Morgagni-Larrey’s hernia. A report of a case. ANZ J Surg 2008; 78: 317-8.

11. Palanivelu C, Rangarajan M, Rajapandian S, Amar V, Parthasarathi R. Laparoscopic repair of adult diaphragmatic hernias and eventration with primary sutured closure and prosthetic reinforcement: a retrospective study. Surg Endosc 2009; 23: 978-85.