Laparoscopic repair of a Morgagni hernia with extra-abdominal transfascial sutures

BMJ Case Rep. 2019 Jan 29;12(1):e227600. doi: 10.1136/bcr-2018-227600.

Abstract

Morgagni hernia is a congenital diaphragmatic hernia. It is rare, usually asymptomatic, and most of the times incidentally discovered during adulthood. A 77-year-old female patient was incidentally diagnosed with Morgagni hernia. Meanwhile, because of abdominal pain she resorted to the emergency department. A CT scan was performed. A laparoscopic repair with extra-abdominal transfascial sutures was conducted. At 3-month follow-up, the patient is asymptomatic. Surgical repair of Morgagni hernia is always indicated because of the risk of strangulation of hernia contents. Minimal invasive surgery is the gold standard, and laparoscopy is the preferred approach. Morgagni hernia does not have an anterior rim, which makes it technically difficult to close the defect. Extra-abdominal transfascial technique was used to repair the defect, eliminating the need for intracorporeal sutures. For small defects, simple repair with non-absorbable sutures using extra-abdominal transfascial technique is easy and efficient.

Keywords: General Surgery; Plastic And Reconstructive Surgery.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Diaphragm / diagnostic imaging
  • Diaphragm / surgery
  • Female
  • Hernias, Diaphragmatic, Congenital / diagnostic imaging*
  • Hernias, Diaphragmatic, Congenital / surgery*
  • Humans
  • Laparoscopy / methods*
  • Sutures*
  • Tomography, X-Ray Computed / methods