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Transabdominal approach in the surgical management of Morgagni hernia
Mehmet Yilmaz1, Burak Isik, Sacit Coban
1Department of General Surgery, School of Medicine, Inonu University, Turgut Ozal Medical Center, 44069 Malatya, Turkey.
Purpose:
Morgagni hernias are uncommon diaphragmatic hernias that are generally asymptomatic, and so far only limited data have been reported. The objective of this retrospective study was to evaluate the outcome of patients presenting with a complicated Morgagni hernia and who undergo a transabdominal repair.
Methods:
Between September 1999 and October 2005, 11 patients with Morgagni hernia were operated on in our department. Eight of them had acute presentations because of a complicated Morgagni hernia. The patient demographics, presenting symptoms, operative approach, and complications were collected. The postoperative course was evaluated for morbidity and mortality.
Results:
The patients' ages ranged from 42 to 85 years (mean 69.4). Two (18.2%) patients were male and nine (81.8%) patients were female. Chest roentgenograms, computed tomography, and contrast meal studies were used as diagnostic utilities. A transabdominal approach was used for all patients. One patient died due to pulmonary failure. The mean follow-up was 2.8 years. There was no recurrence or symptoms regarding the operation in the remaining patients.
Conclusion:
We recommend the transabdominal approach in patients with Morgagni hernia as it makes it easy to reduce the hernia contents and repair of the hernia sac. Moreover, when complicated with strangulation, incarceration or perforation, a surgical repair through a transabdominal approach is mandatory.
Insights
Transabdominal repair is effective for complicated Morgagni hernias, showing no recurrence in a 2.8-year follow-up. This approach is recommended for reducing hernia contents and sac repair, especially in cases of strangulation or perforation.
Area of Science:
- General Surgery
- Thoracic Surgery
- Gastroenterology
Background:
- Morgagni hernias are rare diaphragmatic defects.
- They are often asymptomatic, with limited reported data.
- Complicated Morgagni hernias require prompt surgical evaluation.
Purpose of the Study:
- To evaluate the outcomes of transabdominal repair for complicated Morgagni hernias.
- To assess the safety and efficacy of this surgical approach.
- To provide data on patient demographics and clinical presentations.
Main Methods:
- Retrospective study of 11 patients undergoing Morgagni hernia repair (Sept 1999 - Oct 2005).
- Focus on 8 patients with acute presentations due to complicated hernias.
- Data collected on demographics, symptoms, operative approach, and postoperative course.
Main Results:
- Mean patient age was 69.4 years (range 42-85); 81.8% were female.
- Transabdominal repair was used for all cases.
- One mortality due to pulmonary failure; no recurrence or symptoms in others over a mean 2.8-year follow-up.
Conclusions:
- Transabdominal repair facilitates hernia content reduction and sac repair.
- This approach is mandatory for complicated Morgagni hernias (strangulation, incarceration, perforation).
- The study recommends the transabdominal approach for Morgagni hernia management.
