Gastric volvulus through a Morgagni hernia: multidetector computed tomography diagnosis

Area of Science:

• Gastroenterology
• Thoracic Surgery
• Diagnostic Imaging

Background:

• Morgagni hernias (HM) are uncommon congenital diaphragmatic defects, representing only 3% of adult diaphragmatic hernias.
• They can present with vague or acute symptoms, often mimicking other abdominal pathologies.
• Acute gastric volvulus is a rare but life-threatening complication.

Observation:

• An 81-year-old male presented with symptoms suggestive of acute gastric outlet obstruction.
• Initial diagnosis was suspected via plain abdominal and chest radiographs.
• A rare case of acute gastric volvulus within a Morgagni hernia was identified.

Findings:

• Multidetector computed tomography (MDCT) provided a safe, complete, and accurate preoperative anatomical diagnosis.
• MDCT is crucial for diagnosing complex thoracic-abdominal junction conditions.
• The study details the anatomy, clinical presentation, and management of Morgagni hernias.

Implications:

• This case underscores the importance of considering rare diagnoses like gastric volvulus in Morgagni hernias.
• MDCT is invaluable for rapid and precise diagnosis in acute surgical emergencies involving the thoracic-abdominal junction.
• Early and accurate diagnosis using MDCT can significantly improve patient outcomes.