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Case Reports
. 2008 Jul 9;2(2):232-7.
doi: 10.1159/000142371.

Bilateral Morgagni Hernia: Primary Repair without a Mesh

Vassilios Papanikolaou  1 , Dimitrios Giakoustidis, Paraskevi Margari, Nikolaos Ouzounidis, Nikolaos Antoniadis, Alexander Giakoustidis, Dimitrios Kardasis, Dimitrios Takoudas
Affiliations
Case Reports

Bilateral Morgagni Hernia: Primary Repair without a Mesh

Vassilios Papanikolaou et al. Case Rep Gastroenterol. .

Abstract

We present a case of bilateral Morgagni hernia in a 68-year-old male with an intermittent history of progressive onset of breath shortness and occasional cardiac arrhythmias. Diagnosis was made by clinical examination and the findings in a plain chest radiograph and was confirmed by computed tomography scan. The patient was operated electively and subjected to a transabdominal approach. A bilateral subcostal incision revealed a large right side anterior diaphragmatic defect with a hernia containing the ascending colon, the majority of the transverse colon and a huge amount of omentum. Also a second smaller defect was found on the left side with no hernia inside. After large bowel and omentum had been taken down to the peritoneal cavity, both defects were primarily closed using interrupted nylon sutures without the use of a mesh. The patient recovered very well, had an uneventful postoperative course and was released on the 5th postoperative day. 15-month follow-up failed to reveal any signs of recurrence.

Keywords: Bilateral Morgagni hernia; Mesh; Transabdominal approach.

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Figures

Fig. 1
Fig. 1
CT scan of the lungs and abdomen showing part of the bowel and omentum in the chest.
Fig. 2
Fig. 2
Transabdominal approach through a bilateral subcostal incision, showing part of the large bowel and omentun inside the right defect. The left defect is not shown.
Fig. 3
Fig. 3
Intraoperative photograph showing the right large defect after large bowel and omentum was taken down.
Fig. 4
Fig. 4
Final repair of both defects after excision of the right hernia sac with interrupted nylon sutures.
See this image and copyright information in PMC

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