Costa Almeida Carlos, Caroço Teresa Vieira, Nogueira Oriana, Infuli Armando
Surgery C, Centro Hospitalar e Universitario de Coimbra EPE, Coimbra, Portugal.
BMJ Case Rep. 2019 Jan 29;12(1):e227600. doi: 10.1136/bcr-2018-227600.
Morgagni hernia is a congenital diaphragmatic hernia. It is rare, usually asymptomatic, and most of the times incidentally discovered during adulthood. A 77-year-old female patient was incidentally diagnosed with Morgagni hernia. Meanwhile, because of abdominal pain she resorted to the emergency department. A CT scan was performed. A laparoscopic repair with extra-abdominal transfascial sutures was conducted. At 3-month follow-up, the patient is asymptomatic. Surgical repair of Morgagni hernia is always indicated because of the risk of strangulation of hernia contents. Minimal invasive surgery is the gold standard, and laparoscopy is the preferred approach. Morgagni hernia does not have an anterior rim, which makes it technically difficult to close the defect. Extra-abdominal transfascial technique was used to repair the defect, eliminating the need for intracorporeal sutures. For small defects, simple repair with non-absorbable sutures using extra-abdominal transfascial technique is easy and efficient.
莫尔加尼疝是一种先天性膈疝。它很罕见,通常无症状,大多在成年期偶然发现。一名77岁女性患者偶然被诊断为莫尔加尼疝。同时,由于腹痛她前往急诊科就诊。进行了CT扫描。采用经腹外筋膜缝合的腹腔镜修补术。在3个月的随访中,患者无症状。由于存在疝内容物绞窄的风险,莫尔加尼疝总是需要进行手术修补。微创手术是金标准,腹腔镜检查是首选方法。莫尔加尼疝没有前缘,这使得关闭缺损在技术上具有挑战性。采用腹外经筋膜技术修复缺损,无需体内缝合。对于小缺损,使用腹外经筋膜技术用不可吸收缝线进行简单修补既简单又有效。