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成人 Morgagni 疝:一例报告。

Morgagni hernia in adult: A case report.

作者信息

Kuikel Sandip, Shrestha Sanjib, Thapa Sital, Maharjan Narendra, Kandel Bishnu Prasad, Lakhey Paleswan Joshi

机构信息

Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, Kathmandu, Nepal.

Maharajgunj Medical Campus, Tribhuvan University, Institute of Medicine, Kathmandu, Nepal.

出版信息

Int J Surg Case Rep. 2021 Aug;85:106286. doi: 10.1016/j.ijscr.2021.106286. Epub 2021 Aug 6.

Abstract

INTRODUCTION AND IMPORTANCE

Morgagni Hernia is a congenital diaphragmatic hernia but can rarely present in adults. It occurs due to a congenital defect in the development of the diaphragm. Here we present a case of symptomatic Morgagni hernia diagnosed in a 53 years' female.

CASE PRESENTATION

A 53 years' female presented with recurrent chest symptoms and was found to have bowel contents herniated into the right hemithorax on chest X-ray and CECT. Reduction of hernia was done laparoscopically and the hernia was repaired with non-absorbable suture in an interrupted manner.

CLINICAL DISCUSSION

Morgagni hernias are mostly diagnosed incidentally on a chest radiograph or can present with cardiorespiratory or abdominal symptoms. Our case was an adult who was diagnosed to have Morgagni hernia presenting with chest symptoms. The investigation of choice to diagnose and evaluate this condition is CECT of chest and repair of hernia without the use mesh is advised in asymptomatic cases also due to feared complications like strangulation and incarceration.

CONCLUSION

The treatment of Morgagni Hernia is primary surgical repair which can be done either transthoracically or transabdominally. It is advised that surgical repair should be done even in asymptomatic cases.

摘要

引言与重要性

莫尔加尼疝是一种先天性膈疝,但在成人中很少见。它是由于膈肌发育中的先天性缺陷所致。在此,我们报告一例在一名53岁女性中诊断出的有症状的莫尔加尼疝病例。

病例介绍

一名53岁女性因反复出现胸部症状就诊,胸部X线和CT检查发现有肠内容物疝入右胸腔。通过腹腔镜进行疝还纳,并用不可吸收缝线间断修补疝。

临床讨论

莫尔加尼疝大多在胸部X线检查时偶然发现,或可表现为心肺或腹部症状。我们的病例是一名被诊断为有胸部症状的莫尔加尼疝的成年人。诊断和评估这种疾病的首选检查是胸部CT,对于无症状病例,由于担心诸如绞窄和嵌顿等并发症,也建议不使用补片进行疝修补。

结论

莫尔加尼疝的治疗是一期手术修补,可经胸或经腹进行。建议即使在无症状病例中也应进行手术修补。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0d7d/8358627/59f347a98d6c/gr1.jpg

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