Menditto Vincenzo Giannicola, Cavicchi Angelo, Marchetti Giorgio, Marzioni Marco, Braccioni Francesco, Polonara Stefano
Department of Emergency Medicine and Surgery, Università Politecnica delle Marche, Ospedali Riuniti di Ancona, Via Conca n. 71, Ancona, Italy.
Ann Thorac Cardiovasc Surg. 2011;17(1):77-80. doi: 10.5761/atcs.cr.09.01484.
A hernia of Morgagni (also called hernia of Morgagni-Larrey) is a congenital herniation of abdominal contents into the thoracic cavity through a retrosternal diaphragmatic defect. The Morgagni hernia can create uncertainty in its diagnosis and difficulty for subsequent treatment. If after clinical examination and x-ray we suspect the hernia, computed tomography imaging should be the desired imaging method to confirm the diagnosis. Surgery is the only definitive treatment. When a patient presents signs and symptoms of incarceration or strangulation, emergency surgery is required. We report the first life-threatening case of an association between a hernia of Morgagni and a mediastinal lipoma. We present an adult patient with mediastinal lipoma and a right incarcerated hernia of Morgagni with engagement of the stomach, the duodenum and the transverse colon, successfully treated without complications. To our knowledge, this is the first report of an association between those two rare entities in an acute setting. We discuss the differential diagnosis and physiopathology of the condition, referring to published reports.
莫尔加尼疝（也称为莫尔加尼 - 拉雷疝）是腹腔内容物通过胸骨后膈肌缺损先天性疝入胸腔。莫尔加尼疝在诊断上可能存在不确定性，后续治疗也有困难。如果经过临床检查和X光检查后怀疑有疝，计算机断层扫描成像应是用于确诊的理想成像方法。手术是唯一的确定性治疗方法。当患者出现嵌顿或绞窄的体征和症状时，需要进行急诊手术。我们报告了首例莫尔加尼疝与纵隔脂肪瘤相关的危及生命的病例。我们介绍了一名成年患者，患有纵隔脂肪瘤和右侧嵌顿性莫尔加尼疝，胃、十二指肠和横结肠均受累，成功治疗且无并发症。据我们所知，这是这两种罕见病症在急性情况下相关联的首例报告。我们参考已发表的报告讨论了该病症的鉴别诊断和病理生理学。
