Imagami Toru, Oe Yasumitsu, An Byonggu, Takao Nobuyuki, Togawa Takeshi, Mizumoto Akiyoshi
Department of Digestive Surgery and Peritoneal Dissemination Center, Omi Medical Center, 1660, Yabase, Kusatsu, Shiga 525-8585 Japan.
Int Cancer Conf J. 2023 Jul 5;12(4):263-267. doi: 10.1007/s13691-023-00614-w. eCollection 2023 Oct.
Both pseudomyxoma peritonei and Morgagni hernias in adults are rare clinical conditions. A 70-year-old woman who was diagnosed with pseudomyxoma peritonei with Morgagni hernia underwent cytoreductive surgery and primary repair. Pseudomyxoma peritonei causes increased intra-abdominal pressure that may lead to acquired congenital diaphragmatic hernia when there is a local fragility in the diaphragmatic musculature. Parietal peritonectomy of the right diaphragmatic peritoneum can safely remove the hernia sac. The high rate of infections associated with cytoreductive surgery causes hesitation for concurrent mesh repair for Morgagni hernia. This is the first report of pseudomyxoma peritonei with Morgagni hernia. Cytoreductive surgery including parietal peritonectomy of the right diaphragmatic peritoneum plus primary repair of hernial defect was performed safely and successfully, which achieved positive short-term results for patients with pseudomyxoma peritonei-associated Morgagni hernia.
成人腹膜假黏液瘤和 Morgagni 疝均为罕见的临床病症。一名 70 岁被诊断为腹膜假黏液瘤合并 Morgagni 疝的女性接受了减瘤手术及一期修补术。腹膜假黏液瘤会导致腹内压升高，当膈肌肌肉组织存在局部脆弱性时，可能会引发后天性先天性膈疝。右侧膈肌腹膜的壁层腹膜切除术可安全地切除疝囊。与减瘤手术相关的高感染率使得对于 Morgagni 疝同时进行补片修补存在顾虑。这是关于腹膜假黏液瘤合并 Morgagni 疝的首例报告。包括右侧膈肌腹膜壁层腹膜切除术及疝缺损一期修补术的减瘤手术安全且成功地实施，对于腹膜假黏液瘤相关的 Morgagni 疝患者取得了积极的短期效果。
