Sanford Zachary, Weltz Adam S, Brown Jermaine, Shockcor Nicole, Wu Nan, Park Adrian E
1 Anne Arundel Medical Center, Annapolis, MD, USA.
2 University of Maryland Medical Center, Baltimore, MD, USA.
Surg Innov. 2018 Aug;25(4):389-399. doi: 10.1177/1553350618777053. Epub 2018 May 29.
Anteromedial subcostosternal defects, also known as a diaphragmatic hernia of Morgagni (MH), allow potentially life-threatening herniation of the abdominal organs into the thorax. Constituting only a small fraction of all types of congenital diaphragmatic hernias, correct diagnosis of MH is often delayed, owing in large part to nonspecific associated respiratory and gastrointestinal complaints. Once identified, the primary management for both symptomatic and incidentally discovered asymptomatic cases of MH are surgical correction because the herniated contents present increasing risk for strangulation. Various thoracic and abdominal surgical approaches have been described without a clear consensus on preference for operative repair technique. In this article, the literature regarding management of MH within the past decade is reviewed, and an illustrative case of laparoscopic repair of a MH with novel reinforcement using a Falciform ligament onlay flap is presented.
肋胸骨前内侧缺损，也称为莫尔加尼膈疝（MH），可导致腹部器官疝入胸腔，这可能危及生命。MH仅占所有类型先天性膈疝的一小部分，由于其相关的呼吸和胃肠道症状缺乏特异性，MH的正确诊断常常延迟。一旦确诊，有症状的以及偶然发现的无症状MH病例的主要治疗方法都是手术矫正，因为疝入的内容物发生绞窄的风险在不断增加。已经描述了各种胸腹部手术方法，但对于手术修复技术的偏好尚未达成明确共识。本文回顾了过去十年中关于MH治疗的文献，并展示了一例采用镰状韧带覆盖瓣进行新型加固的腹腔镜修复MH的病例。
