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Intrathoracic intestinal diverticulum in a late presenting congenital bilateral diaphragmatic hernia: a case report

Ruth Gómez-Rosales, Santiago Petersen-Morfín1, Miguel Haro-García

  • 1Department of Surgery, Hospital Civil de Guadalajara Fray Antonio Alcalde, Calle Hospital 278, Guadalajara, CP 44280, Mexico. santiagopetersen@gmail.com.

Journal of Medical Case Reports
|January 1, 2014
PubMed

Insights

This case report details a rare bilateral Morgagni-Larrey diaphragmatic hernia in an adult, presenting with intestinal obstruction. This unique case highlights the importance of considering such hernias in adult diagnoses.

Area of Science:

  • Medical Case Reports
  • Surgical Pathology
  • Gastroenterology

Background:

  • Diaphragmatic hernias account for 3% of all diaphragm defects.
  • Bilateral diaphragmatic hernias are exceptionally rare, predominantly seen in pediatric populations.
  • This report presents a unique case of bilateral Morgagni-Larrey diaphragmatic hernia with intrathoracic intestinal diverticulum in an adult.

Purpose of the Study:

  • To report the first known case of bilateral Morgagni-Larrey diaphragmatic hernia with an intrathoracic intestinal diverticulum.
  • To emphasize the consideration of rare diaphragmatic hernias in adult intestinal obstruction diagnoses.

Main Methods:

  • A 37-year-old male presented with symptoms of intestinal obstruction.
  • Diagnostic imaging (X-rays) revealed herniated abdominal contents in both hemithoraces.
  • Surgical intervention via laparotomy identified and repaired bilateral Morgagni-Larrey defects.

Main Results:

  • The patient had a Morgagni-Larrey hernia with a sac containing small bowel, a large diverticulum, colon, and epiploic fat in the thorax.
  • Herniated contents were reduced, and diaphragmatic defects were repaired using non-absorbable sutures.
  • The patient experienced no postoperative complications.

Conclusions:

  • Bilateral congenital diaphragmatic hernias are exceedingly rare in adults.
  • Adult intestinal obstruction, even without respiratory symptoms, warrants consideration of diaphragmatic hernias.
  • This is the first documented instance of a prolapsed intestinal diverticulum associated with bilateral diaphragmatic hernias.
Abstract

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