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Pediatric Morgagni diaphragmatic hernia: a descriptive study
Jamie Golden1, Wesley E Barry1, Gene Jang1
1Children's Hospital Los Angeles, Division of Pediatric Surgery, 4650 Sunset Blvd, Mailstop 100, Los Angeles, CA, 90027, USA.
Insights
Morgagni hernias (MH) are rare congenital defects. This study found MH has a male predominance, often causes pulmonary symptoms, and surgical repair yields excellent outcomes with no recurrences.
Area of Science:
- Pediatric Surgery
- Congenital Abnormalities
- Diaphragmatic Hernias
Background:
- Morgagni hernia (MH) represents a rare subset (3-4%) of congenital diaphragmatic hernias.
- Limited data exists on the characteristics and management of this specific defect.
- Understanding MH is crucial for improving pediatric surgical care.
Purpose of the Study:
- To characterize pediatric patients diagnosed with Morgagni hernia.
- To analyze surgical techniques employed for MH repair.
- To evaluate patient outcomes following MH correction.
Main Methods:
- Retrospective review of pediatric patients (0-18 years) with MH from 2002-2014.
- Evaluation of patient demographics, clinical presentation, and operative details.
- Assessment of surgical outcomes, including complications and recurrence.
Main Results:
- Twenty-six pediatric patients with MH were identified; 77% were male.
- Median age at diagnosis was 14.75 months, with 50% presenting symptomatically.
- Laparoscopic repair was common (16 cases), with colon most frequently herniated; no recurrences were observed.
Conclusions:
- Congenital Morgagni hernia demonstrates a male predilection and often presents with pulmonary issues.
- Surgical outcomes for MH are generally excellent, irrespective of the approach used.
- This study highlights the rarity and favorable prognosis of MH in pediatric patients.
Introduction:
The Morgagni hernia (MH) accounts for 3-4% of congenital diaphragmatic hernias. There is a paucity of data regarding this rare defect. The purpose of this study is to describe the characteristics of children with MH, surgical approaches for repair, and patient outcomes.
Methods:
Pediatric patients (ages 0-18) with a MH from 2002 to 2014 at a single, freestanding pediatric hospital were retrospectively reviewed. Patient presentation, demographics, operative methods and findings, and outcomes were evaluated.
Results:
Twenty-six infants and children with a congenital MH were treated. There were 20 males (77%) and six females (23%) with a median age at diagnosis of 14.75 months (range 1 week to 13 years). Half were symptomatic. Sixteen hernias were repaired laparoscopically, nine by an open approach, and one laparoscopic converted to open. Colon was the most commonly herniated organ (N = 14). Hernia sacs were found in 22 patients of which, 20 were resected. Two patients underwent treatment with ECLS. There was one mortality in a patient who underwent repair on ECLS in the setting of an omphalocele and SVC obstruction. There were no recurrences in our sample.
Conclusion:
In this series, congenital MH appears to have a male predominance, frequently presents with pulmonary symptoms, and has excellent outcomes regardless of operative approach.
