Bilateral incarcerated Morgagni hernia with bowel obstruction: A case report
Minh Thao Nguyen1, Anh Vu Pham1
1Digestive Surgery Department, Hue University of Medicine and Pharmacy Hospital, Hue University of Medicine and Pharmacy, Hue University, Hue City, Viet Nam.
Abstract:
Morgagni hernia is a rare congenital diaphragmatic hernia associated with the minor retro-xiphoid region between the sternal and costal attachments. The bilateral and complicated Morgagni hernia occurred exceptionally rarely, at a rate of 4% and 6.5%. An 81-year-old woman with occasional constipation went to the emergency department for epigastric pain and vomiting 3 days before. She could no longer pass gas that caused abdominal distention. Clinical examination and ultrasound showed partial bowel obstruction, an unspecified cause. She received nil per os, nasogastric decompression. The abdominal and chest computed tomography Scan showed the bilateral diaphragmatic hernia, and the dilated loops of the cecum and ascending colon were 7 cm. She required an emergency operation to resolve the etiology of bowel obstruction. The midline incision was chosen to release the hernia contents and repair the posterior sternal defects with Polypropylene mesh. An abdominal approach can solve a bilateral incarcerated Morgagni hernia.
Insights
A rare bilateral Morgagni hernia caused bowel obstruction in an elderly woman. Surgical repair via a midline incision successfully resolved the condition, highlighting the abdominal approach for such complex cases.
Area of Science:
- Gastroenterology
- Surgical Innovation
Background:
- Morgagni hernia is a rare congenital diaphragmatic defect.
- Bilateral and complicated Morgagni hernias are exceptionally rare.
Observation:
- An 81-year-old woman presented with symptoms of partial bowel obstruction, including epigastric pain, vomiting, and abdominal distention.
- Imaging revealed a bilateral diaphragmatic hernia causing cecal and ascending colon dilation.
Findings:
- The patient underwent emergency surgery for incarcerated bilateral Morgagni hernia.
- A midline incision allowed for hernia content release and repair of sternal defects with polypropylene mesh.
Implications:
- This case demonstrates the successful management of a rare bilateral incarcerated Morgagni hernia.
- An abdominal approach is effective for resolving bilateral incarcerated Morgagni hernias and associated bowel obstruction.
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