Contents
Scroll to:
Morgagni-Larrey hernia in an adult patient
https://doi.org/10.57256/2949-0715-2022-1-64-69
Abstract
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.
For citations:
Makhutov V., Lebedeva D., Shevchenko D., Grigoryev E. Morgagni-Larrey hernia in an adult patient. Baikal Medical Journal. 2022;1(1):64-69. (In Russ.) https://doi.org/10.57256/2949-0715-2022-1-64-69
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.
References
1. Morgagni G.B. The seats and causes of diseases investigated by anatomy; in five books. Vol. 2. Moscow: Nobel Press; 2012:792.
2. Плаксин С.А. Диагностика и лечение грыж Морганьи-Ларрея. Хирургия. Журнал им. Н.И. Пирогова. 2022;(2):24-29. [Plaksin SA. Diagnostics and treatment of Morgagni-Larrey hernia. Pirogov Russian Journal of Surgery. 2022;(2):24 29. (In Russian)]. DOI: 10.17116/hirurgia202202124
3. Dumpa V., Chandrasekharan P. Congenital diaphragmatic hernia. [Updated 2022 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022. Available from: https://www.ncbi.nlm.nih.gov/books/NBK556076/
4. Slioui B, Abdellaoui M, Belabbes S, Dafiri R. Une association malformative exceptionnelle: situs inversus totalis et hernie rétro-costo-xyphoidienne [An exceptional malformative association: situs inversus totalis and retro-costo-xyphoidian hernia]. Pan Afr Med J. 2019;32:167. Published 2019 Apr 9. DOI: 10.11604/pamj.2019.32.167.6558
5. Arikan S, Dogan MB, Kocakusak A, et al. Morgagni's Hernia: Analysis of 21 Patients with Our Clinical Experience in Diagnosis and Treatment. Indian J Surg. 2018;80(3):239-244. DOI: 10.1007/s12262-016-1580-0
6. Lev-Chelouche D, Ravid A, Michowitz M, Klausner JM, Kluger Y. Morgagni hernia: unique presentations in elderly patients. J Clin Gastroenterol. 1999;28(1):81-82. DOI: 10.1097/00004836-199901000-00022
7. Ipek T, Altinli E, Yuceyar S, et al. Laparoscopic repair of a Morgagni-Larrey hernia: report of three cases. Surg Today. 2002;32(10):902-905. DOI:10.1007/s005950200177
8. Marín-Blazquez AA, Candel MF, Parra PA, et al. Morgagni hernia: repair with a mesh using laparoscopic surgery. Hernia. 2004;8(1):70-72. DOI:10.1007/s10029-003-0145-x
9. Horton JD, Hofmann LJ, Hetz SP. Presentation and management of Morgagni hernias in adults: a review of 298 cases. Surg Endosc. 2008;22(6):1413-1420. DOI:10.1007/s00464-008-9754-x
10. Young MC, Saddoughi SA, Aho JM, et al. Comparison of Laparoscopic Versus Open Surgical Management of Morgagni Hernia. Ann Thorac Surg. 2019;107(1):257-261. DOI:10.1016/j.athoracsur.2018.08.021
11. Agarwal N, Dokania MK, Kumar GR, Manda DG, Singh Rana AK. Significant Liver Atrophy Due to Vascular Compromise Associated With Adult Congenital Diaphragmatic Hernia. Cureus. 2021;13(8):e17158. DOI:10.7759/cureus.17158
12. Oppelt PU, Askevold I, Bender F, et al. Morgagni-Larrey diaphragmatic hernia repair in adult patients: a retrospective single-center experience. Hernia. 2021;25(2):479-489. DOI:10.1007/s10029-020-02147-0
13. Ryan JM, Rogers AC, Hannan EJ, Mastrosimone A, Arumugasamy M. Technical description of laparoscopic Morgagni hernia repair with primary closure and onlay composite mesh placement. Hernia. 2018;22(4):697-705. DOI:10.1007/s10029-018-1760-x
About the Authors
V.N. Makhutov
Irkutsk regional clinical hospital, winner of the “Mark of the Honor” award
D.V. Lebedeva
Irkutsk State Medical University
D.A. Shevchenko
Irkutsk regional clinical hospital, winner of the “Mark of the Honor” award
E.G. Grigoryev
Irkutsk State Medical University,
Irkutsk Scientific Centre of Surgery and Traumatology
Supplementary files
Review
For citations:
Makhutov V., Lebedeva D., Shevchenko D., Grigoryev E. Morgagni-Larrey hernia in an adult patient. Baikal Medical Journal. 2022;1(1):64-69. (In Russ.) https://doi.org/10.57256/2949-0715-2022-1-64-69
Views:
3437
