Komatsu Teruya, Takahashi Yutaka
Department of General Thoracic Surgery, Kobe City Medical Center General Hospital, Japan.
Int J Surg Case Rep. 2013;4(3):302-4. doi: 10.1016/j.ijscr.2012.12.010. Epub 2013 Jan 16.
Morgagni's hernia is a congenital herniation of abdominal viscera into the thoracic cavity through a retrosternal diaphragmatic defect.
We present a case of incarcerated Morgagni hernia in a 69-year-old woman. Three years previously, she had undertaken a video-assisted thoracoscopic resection (VATS) of a mediastinal mass, which had been mistaken for a lipoma. Following the primary repair of the hernia at emergency laparotomy, the patient was discharged home uneventfully.
Irrespective of the radiologically characteristic findings of our case, the possibility of Morgagni hernia had not been entertained at the first operation. Thorough exploration around the diaphragm at the first VATS operation could have revealed the Morgagni hernia, ultimately avoiding the hernia-related complication such as an incarceration.
Morgagni hernia as a differential diagnosis in case of anterior mediastinal mass should not be missed.
莫尔加尼疝是腹腔脏器通过胸骨后膈肌缺损先天性疝入胸腔。
我们报告一例69岁女性的绞窄性莫尔加尼疝。三年前，她接受了电视辅助胸腔镜手术（VATS）切除一个曾被误诊为脂肪瘤的纵隔肿物。在急诊剖腹手术对疝进行一期修补后，患者顺利出院。
尽管我们病例有放射学特征性表现，但首次手术时并未考虑莫尔加尼疝的可能性。首次VATS手术时对膈肌周围进行彻底探查本可发现莫尔加尼疝，最终避免疝相关并发症如绞窄。
莫尔加尼疝作为前纵隔肿物的鉴别诊断不应被漏诊。
