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Laparoscopic patch repair of a Morgagni hernia in Menkes disease
Silvia Ceccanti1, Mario Mastrangelo2, Gianmarco Andreoli3
1Pediatric Surgery Unit, Azienda Ospedaliera Universitaria Policlinico Umberto I, Sapienza University of Rome, Rome, Italy.
Abstract:
The association between Morgagni hernia and Menkes disease has not yet been described. Here, we report such a rare association in an 8-year-old boy who presented with subocclusive symptoms. He successfully underwent laparoscopic repair with a patch. The patch was fixed to the anterior abdominal wall by using transfascial sutures with extracorporeal knot tying and to the remaining edges of the diaphragmatic defect by using intracorporeal suturing and spiral tacks. At the 2-year follow-up, the child remained recurrence-free and without gastrointestinal symptoms. The potential relationship between the two conditions and the controversial use of spiral tacks to affix the mesh to the diaphragm are also discussed.
Insights
This study reports a rare association between Morgagni hernia and Menkes disease in an 8-year-old boy. Laparoscopic repair was successful, with no recurrence at 2-year follow-up.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Medical Genetics
Background:
- Morgagni hernia, a congenital diaphragmatic defect, is uncommon.
- Menkes disease is a rare X-linked genetic disorder affecting copper metabolism.
- The co-occurrence of Morgagni hernia and Menkes disease has not been previously documented.
Observation:
- An 8-year-old boy presented with subocclusive symptoms.
- The patient was diagnosed with both Morgagni hernia and Menkes disease.
- He underwent successful laparoscopic repair of the Morgagni hernia.
Findings:
- The laparoscopic repair utilized a patch secured with transfascial sutures and intracorporeal suturing with spiral tacks.
- The patient experienced no recurrence of the hernia or gastrointestinal symptoms at a 2-year follow-up.
- This case highlights a novel association between these two distinct conditions.
Implications:
- This case expands the clinical spectrum of Morgagni hernia presentations.
- It prompts consideration of Morgagni hernia in patients with Menkes disease presenting with abdominal symptoms.
- Further research is needed to explore the potential pathogenetic links and the safety of spiral tacks in diaphragmatic repair.
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