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Retrosternal (Morgagni) hernia with small bowel obstruction secondary to a Richter's incarceration
F M Kimmelstiel1, L O Holgersen, C Hilfer
1Department of Surgery, St Luke's-Roosevelt Hospital Center, New York, NY 10025.
Abstract:
Retrosternal (Morgagni) hernias in children are usually asymptomatic or may be associated with mild respiratory distress or gastrointestinal symptoms. Incarceration of bowel in a retrosternal hernia is unusual with only four reported cases, all in adult patients. This report details an unusual case of complete small bowel obstruction in which the Morgagni hernia sac itself contained the defect through which a portion of small bowel incarcerated as a Richter's hernia.
Insights
Retrosternal hernias are rare in children and usually asymptomatic. This case report highlights a rare instance of a child experiencing a complete small bowel obstruction due to a Morgagni hernia complication.
Area of Science:
- Pediatric surgery
- Gastrointestinal surgery
- Congenital abnormalities
Background:
- Retrosternal (Morgagni) hernias are uncommon congenital abnormalities.
- In children, these hernias are typically asymptomatic or present with mild symptoms.
Observation:
- This report details a rare case of a child with a retrosternal hernia.
- The child presented with a complete small bowel obstruction.
Findings:
- Incarceration of bowel within a retrosternal hernia is exceptionally rare, with only four prior adult cases reported.
- This pediatric case involved the Morgagni hernia sac itself containing the defect, leading to incarcerated small bowel as a Richter's hernia.
Implications:
- This case underscores the potential for severe complications from retrosternal hernias, even in pediatric patients.
- Highlights the importance of considering Morgagni hernias in the differential diagnosis of pediatric bowel obstruction.
- Suggests that the hernia sac itself can be the site of incarceration, a rare presentation of Richter's hernia.