Simultaneous Operation in a Patient with Coronary Heart Disease, Abnormal Orifice of Coronary Arteries, Morgagni Hernia, Atrial Septal Defect, and Pericardial and Pleural Agenesis

Balcı, Ahmet; Tuygun, Abdullah Kemal; Günay, Rafet; Sensoz, Yavuz; Yurtseven, Nurgül; Alkan, Pinar

doi:10.1532/hsf98.20091180

Cited by 7 publications

(7 citation statements)

References 6 publications

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“…We found 4 reports of heart surgery combined with Morgagni hernia repair in adults [9][10][11][12] ; however, to our knowledge, ours is the first report to describe concomitant aortic surgery and repair of a trauma-induced IDH in an adult.…”

Section: A B Cmentioning

confidence: 77%

Repair of Intrapericardial Diaphragmatic Hernia during Aortic Surgery in a 78-Year-Old Woman

Spiliotopoulos¹,

Cruz²,

Gkotsis³

et al. 2017

Texas Heart Institute Journal

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Intrapericardial diaphragmatic hernias are reported very rarely. Those of congenital origin are most often diagnosed in neonates, and those caused by indirect blunt trauma occur chiefly in adults. The latter type can be asymptomatic; however, the results of a computed tomographic scan can yield a definitive diagnosis. Once discovered, these hernias should be corrected to avoid severe sequelae such as bowel strangulation and necrosis, peritonitis, mediastinitis, and cardiac tamponade. We report the case of a 78-year-old woman who presented for elective ascending aortic aneurysm repair. Computed tomographic angiograms incidentally revealed a large intrapericardial diaphragmatic hernia, which had probably developed years earlier, after a traffic accident. The patient underwent a median sternotomy and repair of the intrapericardial diaphragmatic hernia with use of a bovine pericardial patch, followed by ascending aortic and hemiarch repair, aortic valve repair, and aorto–right coronary artery bypass grafting. We discuss the details of these procedures and alternative treatment options. To our knowledge, this is the first report of concomitant aortic surgery and repair of a trauma-induced intrapericardial diaphragmatic hernia in an adult.

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Section: A B Cmentioning

confidence: 77%

Repair of Intrapericardial Diaphragmatic Hernia during Aortic Surgery in a 78-Year-Old Woman

Spiliotopoulos¹,

Cruz²,

Gkotsis³

et al. 2017

Texas Heart Institute Journal

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“…Of the 171 cases identified from 76 articles in the past decade (Tables 1-3), 13-81 the majority of reported MH repairs were attempted through minimally invasive techniques (31), including laparoscopy (30) and thoracoscopy (1), followed by open abdominal approaches (31) exclusively attempted via laparotomy (31), and finally...…”

Section: Resultsmentioning

confidence: 99%

“…35 The preference for right-sided manifestation owes in large part to the protective occlusion of the left sternocostal triangle by the overlaying pericardium, although herniation into the left hemithorax is still possible particularly in cases of pericardial defects in proximity of the Morgagni foramina. 10,42,69,92,93 It is also possible to have bilateral herniation encompassing both the right as well as left sternocostal triangles, although these are also rare. 35 In the past decade, 57 MH cases have been reported in the literature of which 84% of patients had right-sided diaphragmatic defects, whereas only 11% and 5% had defects of the left side and bilaterally, respectively.…”

Section: Site Of Herniationmentioning

confidence: 99%

Morgagni Hernia Repair: A Review

et al. 2018

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Anteromedial subcostosternal defects, also known as a diaphragmatic hernia of Morgagni (MH), allow potentially life-threatening herniation of the abdominal organs into the thorax. Constituting only a small fraction of all types of congenital diaphragmatic hernias, correct diagnosis of MH is often delayed, owing in large part to nonspecific associated respiratory and gastrointestinal complaints. Once identified, the primary management for both symptomatic and incidentally discovered asymptomatic cases of MH are surgical correction because the herniated contents present increasing risk for strangulation. Various thoracic and abdominal surgical approaches have been described without a clear consensus on preference for operative repair technique. In this article, the literature regarding management of MH within the past decade is reviewed, and an illustrative case of laparoscopic repair of a MH with novel reinforcement using a Falciform ligament onlay flap is presented.

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“…A transthoracic approach is used for large rightsided MH. It enables easier dissection of the hernia sac off the pleural and mediastinal structures with good visualization of the operative field [17]. This approach provides an effective repair of the hernia defect with minimal recurrence [18].…”

Section: Discussionmentioning

confidence: 99%

Symptomatic congenital Morgagni hernia presenting as a chest pain: a case report

et al. 2020

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Background: Morgagni hernia is a rare form of congenital diaphragmatic hernia with a prevalence of 2-3%. It occurs due to a defect on the anterior part of the diaphragm, which allows abdominal organs to penetrate into the thoracic cavity. This condition can be detected during fetal life by routine ultrasonography or late during adult life. Late diagnosis of this condition in adults is extremely rare. According to our literature search, only a few cases of symptomatic hernia in adults have been reported so far. Surgery provides definitive treatment for patients with Morgagni hernia; it is always recommended for symptomatic and asymptomatic adult patients to avoid future complications such as volvulus, small bowel obstruction, incarceration, or strangulation. We report a case of a patient who presented with chest pain due to newly diagnosed congenital diaphragmatic hernia. Case presentation: A 29-year-old unemployed white man with no significant past medical history or family history of coronary artery disease, who was a current smoker with a 1-pack-per-day history, presented to our hospital with a 1-month history of intermittent chest pain. His chest pain was localized to the right side with a pressure-like quality, moderate intensity 4-6/10, nonradiating, and relieved by standing up and worsened by lying flat. His pain was not associated with increase or decrease in activity level. The pain had progressively worsened, which prompted the patient to come to the emergency room. The patient was admitted for further evaluation. A chest x-ray showed a suspected loop of bowel on the right side of the chest. Subsequently, the patient underwent computed tomography of the chest, which revealed a 7-cm defect in the right hemidiaphragm with a large amount of intra-abdominal fat and a loop of the proximal transverse colon within the hernial sac. The patient was evaluated by a surgeon and eventually underwent laparoscopic repair of the diaphragmatic hernia with mesh repair. In follow-up, the patient's symptoms resolved. Conclusion: Morgagni hernia is a rare form of congenital diaphragmatic hernia. It is commonly found either in the first few hours of life or in the antenatal period. It is less common in adults and is usually diagnosed accidentally in asymptomatic patients. Symptomatic adult cases are extremely rare. Respiratory symptoms are the most common presenting symptoms. The primary management for both symptomatic and incidentally discovered asymptomatic cases of Morgagni hernia is surgical correction. Various thoracic and abdominal surgical approaches have been described without a clear consensus on preference for operative repair technique.

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Simultaneous Operation in a Patient with Coronary Heart Disease, Abnormal Orifice of Coronary Arteries, Morgagni Hernia, Atrial Septal Defect, and Pericardial and Pleural Agenesis

Cited by 7 publications

References 6 publications

Repair of Intrapericardial Diaphragmatic Hernia during Aortic Surgery in a 78-Year-Old Woman

Repair of Intrapericardial Diaphragmatic Hernia during Aortic Surgery in a 78-Year-Old Woman

Morgagni Hernia Repair: A Review

Symptomatic congenital Morgagni hernia presenting as a chest pain: a case report

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