Related Experiment Videos
Congenital Morgagni's hernia in infants and children
1Department of Surgery, Tawam Hospital, Al-Ain, Abu-Dhabi, United Arab Emirates.
Insights
Morgagni
Area of Science:
- Pediatric Surgery
- Medical Imaging
- Congenital Abnormalities
Background:
- Morgagni's hernia is a rare congenital diaphragmatic hernia in children.
- It often presents with recurrent chest infections, delaying diagnosis.
- Associated anomalies are common, including malrotation and Down's syndrome.
Purpose of the Study:
- To report the frequency and clinical presentation of Morgagni's hernia in a pediatric cohort.
- To emphasize the role of chest X-ray in early diagnosis.
- To highlight the morbidity associated with delayed diagnosis and treatment.
Main Methods:
- Retrospective review of 52 pediatric congenital diaphragmatic hernia cases.
- Analysis of diagnostic methods including chest X-ray, barium enema, and CT scan.
- Surgical treatment via a transabdominal approach.
Main Results:
- Morgagni's hernia occurred in 5 (9.6%) of the pediatric patients.
- Diagnosis was often suspected after chest X-ray revealed anterior mediastinal opacity or bowel herniation.
- All cases had associated anomalies; 2 presented with malrotation.
Conclusions:
- Morgagni's hernia, while uncommon, appears relatively frequent in this series.
- Early diagnosis via chest X-ray is crucial for children with recurrent chest infections.
- Prompt surgical intervention is necessary to prevent significant morbidity.
Abstract:
Morgagni's hernia is an uncommon type of diaphragmatic hernia in the pediatric age group. Out of 52 children with different types of congenital diaphragmatic hernia that we have treated, 5 (9.6%) had Morgagni's hernia. There were 2 infants and 3 children including one with Down's syndrome. All suffered from repeated attacks of chest infection, and only after a chest X-ray was the diagnosis of Morgagni's hernia suspected. In 2 cases this appeared as an opacity in the anterior mediastinum adjacent to the pericardium; diagnosis was confirmed by barium enema in one and a CT-scan in the other. The remaining 3 cases showed anterior herniation of bowel loops on chest X-ray which was bilateral in one. This bilaterality was confirmed pre-operatively by CT scan. Associated anomalies were present in all cases, including 2 with malrotation. All patients were treated surgically via a transabdominal approach. Our study shows a relative high frequency of Morgagni's hernia in our patients and, although late-presenting Morgagni hernias are relatively benign, it can cause significant morbidity. This calls for early diagnosis and early referral for surgery. Chest X-ray is to be strongly advocated in children with repeated attacks of chest infection.