bmjourБайкальский медицинский журналBaikal Medical Journal2949-0715Irkutsk State Medical University10.57256/2949-0715-2022-1-64-69bmjour-29Research ArticleКлиническое наблюдениеClinical casesГРЫЖА МОРГАНЬИ-ЛАРРЕЯ У ВЗРОСЛОГОMORGAGNI-LARREY HERNIA IN AN ADULT PATIENThttps://orcid.org/0000-0001-7318-7193МахутовВалерий НиколаевичMakhutovV.N.iokb@iokb.ruhttps://orcid.org/0000-0001-7388-1679ЛебедеваДарья ВладимировнаLebedevaD.V.daria_lebe@mail.ruhttps://orcid.org/0000-0002-3620-7949ШевченкоДенис АлександровичShevchenkoD.A.iokb@iokb.ruhttps://orcid.org/0000-0002-5082-7028ГригорьевЕвгений ГеоргиевичGrigoryevE.G.egg.irk@gmail.comГБУЗ "Иркутская ордена "Знак почета" областная клиническая больница"Irkutsk regional clinical hospital, winner of the “Mark of the Honor” awardФГБОУ ВО ИГМУ Минздрава РоссииIrkutsk State Medical UniversityФГБНУ «Иркутский научный центр хирургии и травматологии»РоссияIrkutsk State Medical University, Irkutsk Scientific Centre of Surgery and TraumatologyRussian Federation202210122022116469Copyright © Махутов В.Н., Лебедева Д.В., Шевченко Д.А., Григорьев Е.Г., 20222022Махутов В.Н., Лебедева Д.В., Шевченко Д.А., Григорьев Е.Г.Makhutov V., Lebedeva D., Shevchenko D., Grigoryev E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bmjour.ru/jour/article/view/29

Обсуждается лечение пациента 30 лет с впервые выявленной диафрагмальной грыжей Морганьи-Ларрея. Среди диафрагмальных грыж патология Морганьи-Ларрея встречается в 26 % случаев, чаще справа. Приведены данные о вариантах доступов при абдомино-медиастинальных грыжах. В описанном наблюдении плановое оперативное вмешательство выполнено из лапаротомного доступа. Содержимое грыжи представлено поперечной ободочной кишкой и большим сальником, как и в большинстве случаев по данным литературы. Грыжевой мешок в указанном клиническом случае был удален, пластика дефекта выполнена местными тканями диафрагмы. Учитывая снижение качества жизни при данной патологии, а также риски развития осложнения, целесообразно таким пациентам выполнять оперативное вмешательство в плановом порядке. Остаются нерешенными вопросы выбора оперативного доступа, способа пластики диафрагмы и целесообразности иссечения грыжевого мешка.

The article discusses a treatment of a 30-year-old patient with a newly diagnosed diaphragmatic Morgagni-Larrey hernia. Among diaphragmatic hernias, Morgagni-Larrey pathology occurs in 26 % of cases, mostly on the right side. Data on access options for abdominal-mediastinal hernias are presented. In the presented case report, the planned surgical intervention was performed from laparotomy access. The hernia content was represented by a transverse colon and a large omentum, as in most reported cases. We removed the hernial sac and performed plastic repair of the defect with local diaphragm tissues. Taking into account that the discussed pathology decreases the quality of life and has a risk of complications, it is appropriate to perform elective surgical interventions in such patients. Choice of operative access, technique of diaphragm plastic surgery and need for the hernial sac excision are the matters of further consideration.

грыжа Морганьи-Ларреядиафрагмальные грыжиретростернальные грыжидефект диафрагмыгрыжевой мешоктранспозиция органовMorgagni-Larrey herniadiaphragmatic herniaretrosternal herniadiaphragm defecthernial sacorgan transpositionReferencesMorgagni G.B. The seats and causes of diseases investigated by anatomy; in five books. Vol. 2. Moscow: Nobel Press; 2012:792.Morgagni G.B. The seats and causes of diseases investigated by anatomy; in five books. Vol. 2. Moscow: Nobel Press; 2012:792.Плаксин С.А. Диагностика и лечение грыж Морганьи-Ларрея. Хирургия. Журнал им. Н.И. Пирогова. 2022;(2):24-29 [Plaksin S.A. Diagnostics and treatment of Morgagni-Larrey hernia. Pirogov Russian Journal of Surgery. 2022;(2):24-29 (In Russian)]. https://doi.org/10.17116/hirurgia202202124Plaksin S.A. Diagnostics and treatment of Morgagni-Larrey hernia. Pirogov Russian Journal of Surgery. 2022;(2):24 29 (In Russian). https://doi.org/10.17116/hirurgia202202124Dumpa V., Chandrasekharan P. Congenital diaphragmatic hernia. 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The authors declare that there are no conflicts of interest present.