Papanikolaou Vassilios, Giakoustidis Dimitrios, Margari Paraskevi, Ouzounidis Nikolaos, Antoniadis Nikolaos, Giakoustidis Alexander, Kardasis Dimitrios, Takoudas Dimitrios
Department of Transplant Surgery, Medical School, Aristotle University, Hippokration Hospital, Thessaloniki, Greece.
Case Rep Gastroenterol. 2008 Jul 9;2(2):232-7. doi: 10.1159/000142371.
We present a case of bilateral Morgagni hernia in a 68-year-old male with an intermittent history of progressive onset of breath shortness and occasional cardiac arrhythmias. Diagnosis was made by clinical examination and the findings in a plain chest radiograph and was confirmed by computed tomography scan. The patient was operated electively and subjected to a transabdominal approach. A bilateral subcostal incision revealed a large right side anterior diaphragmatic defect with a hernia containing the ascending colon, the majority of the transverse colon and a huge amount of omentum. Also a second smaller defect was found on the left side with no hernia inside. After large bowel and omentum had been taken down to the peritoneal cavity, both defects were primarily closed using interrupted nylon sutures without the use of a mesh. The patient recovered very well, had an uneventful postoperative course and was released on the 5th postoperative day. 15-month follow-up failed to reveal any signs of recurrence.
我们报告一例68岁男性双侧莫尔加尼疝，患者有进行性气短发作的间歇性病史，偶尔出现心律失常。通过临床检查及胸部X线平片结果做出诊断，并经计算机断层扫描证实。患者接受择期手术，采用经腹入路。双侧肋下切口显示右侧膈肌前部有一个大的缺损，疝内容物包括升结肠、大部分横结肠和大量大网膜。左侧还发现一个较小的缺损，内部无疝。将大肠和大网膜还纳至腹腔后，两个缺损均采用间断尼龙缝线进行一期缝合，未使用补片。患者恢复良好，术后过程顺利，术后第5天出院。15个月的随访未发现任何复发迹象。
