Diaphragmatic Hernia Through the Foramen of Morgagni: Laparoscopic Repair Case Report

Abstract

Laparoscopic repair of a diaphragmatic hernia through the foramen of Morgagni in a 67-year-old woman with symptoms of partial colon obstruction is described. The patient had a prompt and complete recovery with no evidence of recurrence one year after surgery. The technique, which incorporates the rectus abdominal fascia in the repair, may be suitable for other laparoscopic surgical procedures.

Laparoscopic mesh repair of Morgagni hernia in an octogenarian patient

“…The sac is usually not removed; as this may result in massive pneumomediastinum with potential respiratory and circulatory complications. 8 We could find only two case reports of laparoscopic repair of Morgagni hernia on literature review in octogenarian patients. Vinard et al reported an eighty four year old male patient who underwent primary closure of the defect.…”

“…3,4 The first laparoscopic repair was reported by Kuster et al in 1992. 8 Laparoscopy is an excellent way to confirm diagnosis and to repair non-complicated hernia of Morgagni. The hernia sac can be easily viewed through the laparoscope.…”

Morgagni hernia: Report of two cases and brief review of anatomy and literature

“…Failure of fusion of these structures in the retroxiphoid region results in a Morgagni hernia. [3] Specifically, it arises from a septum transversum defect due to failure of closure of the pars sternalis and the seventh costochondral arch, known as Larrey's space. [4] Diaphragmatic hernia through this space was first described by the Italian anatomist Giovanni Morgagni in 1769.…”

“…[8] Acute symptoms may be due to bowel obstruction, but the incidence of this is very low. [2,3] The overwhelming majority of Morgagni hernias are diagnosed in children, though approximately five percent are diagnosed in adults. [1] The most common adult presentation is in middle-aged, overweight women.…”

“…[7,12] The hernia is closed along its transverse axis by suturing the edge of the diaphragm to the retrosternal and retrocostal peritoneum and periosteum. [3,5] About half of the reported hernias are repaired with mesh, and half are repaired primarily. [12] Mesh has been particularly advocated in cases of large defects or muscle weakness.…”