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腹腔镜诊断与治疗 Morgagni 膈疝。病例报告及文献复习。

Laparoscopic diagnosis and treatment of diaphragmatic Morgagni hernia. Case report and review of the literature.

作者信息

Pironi Daniele, Palazzini Giorgio, Arcieri Stefano, Candioli Salvatore, Manigrasso Annarita, Panarese Alessandra, Filippini Angelo

机构信息

Department of Surgical Sciences, University "La Sapienza" of Rome, Italy.

出版信息

Ann Ital Chir. 2008 Jan-Feb;79(1):29-36.

Abstract

BACKGROUND

Morgagni's hernia is a rare and congenital type of diaphragmatic hernia. The majority of these are asymptomatic and diagnosed incidentally during evaluation or treatment for other conditions. When diagnosis is made surgery is mandatory. The Authors report the laparoscopic repair of small Morgagni hernia, followed by review of the literature.

MATERIALS AND METHODS

A case of 55-year-old woman complaining a sensation of tightness in her chest, but especially an oppressive epigastric pain with episodes of fainting fit and breathless is described. The definitive diagnosis was confirmed by laparoscopy. The hernia was repaired laparoscopically using a mesh fixed by hernia stapler after excision of the sac.

RESULTS

In the postoperative patients has presented an episode of heart condition due to pericarditis treated pharmacologically. The patient was discharged on the seventh postoperative day symptom-free.

CONCLUSIONS

Laparoscopic technique must be considered as a first line approach for the treatment of Morgagni hernia, easy and safe by carry out. We recommend do not excise hernia sac, even if small, and particular cure in the use of the mesh fixed by metal staples.

摘要

背景

莫尔加尼疝是一种罕见的先天性膈疝。其中大多数无症状,在因其他疾病进行评估或治疗时偶然被诊断出来。一旦确诊,手术是必需的。作者报告了小型莫尔加尼疝的腹腔镜修补术,并对相关文献进行了综述。

材料与方法

描述了一例55岁女性患者,主诉胸部有紧绷感,尤其是上腹部有压迫性疼痛,并伴有昏厥发作和呼吸急促。通过腹腔镜检查确诊。在切除疝囊后,使用疝吻合器固定补片,通过腹腔镜对疝进行修补。

结果

术后患者因心包炎出现一次心脏问题发作,经药物治疗。患者术后第七天无症状出院。

结论

腹腔镜技术应被视为治疗莫尔加尼疝的一线方法,实施起来简便且安全。我们建议即使疝囊较小也不要切除,并且在使用金属吻合器固定补片时要特别小心。

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