Golden Jamie, Barry Wesley E, Jang Gene, Nguyen Nam, Bliss David
Children's Hospital Los Angeles, Division of Pediatric Surgery, 4650 Sunset Blvd, Mailstop 100, Los Angeles, CA, 90027, USA.
Pediatr Surg Int. 2017 Jul;33(7):771-775. doi: 10.1007/s00383-017-4078-3. Epub 2017 Mar 13.
The Morgagni hernia (MH) accounts for 3-4% of congenital diaphragmatic hernias. There is a paucity of data regarding this rare defect. The purpose of this study is to describe the characteristics of children with MH, surgical approaches for repair, and patient outcomes.
Pediatric patients (ages 0-18) with a MH from 2002 to 2014 at a single, freestanding pediatric hospital were retrospectively reviewed. Patient presentation, demographics, operative methods and findings, and outcomes were evaluated.
Twenty-six infants and children with a congenital MH were treated. There were 20 males (77%) and six females (23%) with a median age at diagnosis of 14.75 months (range 1 week to 13 years). Half were symptomatic. Sixteen hernias were repaired laparoscopically, nine by an open approach, and one laparoscopic converted to open. Colon was the most commonly herniated organ (N = 14). Hernia sacs were found in 22 patients of which, 20 were resected. Two patients underwent treatment with ECLS. There was one mortality in a patient who underwent repair on ECLS in the setting of an omphalocele and SVC obstruction. There were no recurrences in our sample.
In this series, congenital MH appears to have a male predominance, frequently presents with pulmonary symptoms, and has excellent outcomes regardless of operative approach.
Morgagni疝（MH）占先天性膈疝的3%-4%。关于这种罕见缺陷的数据很少。本研究的目的是描述MH患儿的特征、修复手术方法及患者预后。
对2002年至2014年在一家独立儿科医院就诊的0至18岁患有MH的儿科患者进行回顾性研究。评估患者的临床表现、人口统计学特征、手术方法及发现以及预后情况。
共治疗26例先天性MH婴幼儿及儿童。其中男性20例（77%），女性6例（23%），诊断时的中位年龄为14.75个月（范围1周-13岁）。半数患者有症状。16例疝通过腹腔镜修复，9例采用开放手术，1例由腹腔镜手术转为开放手术。结肠是最常见的疝入器官（n = 14）。22例患者发现疝囊，其中20例进行了切除。2例患者接受体外膜肺氧合（ECLS）治疗。1例在脐膨出和上腔静脉梗阻情况下接受ECLS修复手术的患者死亡。我们的样本中无复发情况。
在本系列研究中，先天性MH似乎以男性居多，常表现为肺部症状，无论采用何种手术方式，预后均良好。
