Adult morgagni hernia: a single center experience of 5 cases and review of literature

Abstract

Morgagni hernia is a rare congenital anomaly arising through the fusion defect between the septum transversum and sternum. Diagnosis is usually confusing as the presentation may be asymptomatic as well as with respiratory symptoms, abdominal and/or retrosternal pain, abdominal fullness or gastrointestinal obstruction. In this paper, we discussed the clinical presentation and management of this rare situation with five consecutive cases. Between 2009 and 2015, five cases underwent surgery for Morgagni hernia (3 laparoscopic and 2 open repair); one patient had recurrent hernia after 7 months from laparoscopic surgery. This case is the first recurrence in the literature after laparoscopic repair in an adult group. In Morgagni hernias, the only treatment is surgery, which can be performed by transthoracic, transabdominal, laparoscopic or thoracoscopic approaches. The issues of using mesh and reducing the hernia sac are still controversial.

Keywords: Laparoscopic repair; diafragmatic hernia; morgagni hernia.

Figure 1. A. Right paracardiac opacity in chest x-ray. B. Herniated stomach in left Morgagni hernia sac. C. Bilateral Morgagni defects. D. Repair with ePTFE mesh.

Figure 2. A. Herniated stomach and omentum through a 4-cm diaphragmatic defect. B. Hernia sac was reduced into the abdominal cavity. C. Lapa- roscopic primary closure of the defect with polypropylene stitches. D. Intraoperative view after primary repair.