Abstract
Introduction
Morgagni congenital hernia is an intrathoracic protrusion of the abdominal contents by a congenital retrosternal diaphragmatic defect, caused by fusion disorders of the diaphragmatic transverse septum and chondrocostal arches (Larrey slot), triangular spaces located anteriorly between the diaphragmatic bundles [3,5,11].
There is some confusion about the name of this diaphragmatic hernia, with some authors using the term "Morgagni hernia" for the right hernia and "Larrey hernia" for the left hernia[22]. In the literature this type of congenital diaphragmatic defect can also be found under the name of: Morgagni-Larrey hernias, retro-costo-xiphoid, parasternal, retrochondrosteranal, retrosternal, substernal, etc.[5,22].
Morgagni's hernia is relatively rare, accounting for approximately 3-5% of all types of congenital diaphragmatic hernia. About 90% of this type of hernia occurs on the right, 2% on the left, and in 8% of cases bilateral forms are found. The herniated sac is present in over 95% of cases [7, 10, 25].
The incidence of abnormalities associated with Morgani hernia is about 64%, in 30-40% of patients with Down syndrome, and in 23-44% being found congenital heart malformations[4,7]. Other malformations associated with this type of diaphragmatic defect are: Cantrell's pentalogy, Noonan syndrome, Pradere Willi syndrome, Turner syndrome, intestinal malrotation, anorectal malformations, etc.[4,9,10].
References
- Abraham V., Myla Y., Verghese S., Chandran B.S. Morgagni-Larrey hernia – a review of 20 cases. Indian J. Surg. 2012. 74(5):391-5.
- Al-Salem A., Zamakhshary M., Al Mohaidly M., Al-Qahtani A., Abdulla M.R., Naga M.I. Congenital Morgagni hernia: a national multicenter study. J. Pediatr. Surg. 2014. 49:503-7.
- Al-Salem A.H. Congenital hernia of Morgagni in infants and children. J. Surg. 2007. 42(9):1539-43.
- Al-Salem A.H. Congenital Morgagni hernia in infants and children: a national review. Ann. Pediatr. Surg. 2017. 13(4):182-7.
- Arikan S., Dogan M.B., Kocakusak A., Erozi F., Dari S. et al. Morgagni's hernia: analysis of 21 patients with our clinical experience in diagnosis and treatment. Indian J. Surg. 2018. 80(3):239-44.
- Aydin Y., Altuntas A.B., Ulas A.B., Daharli C., Eroglu A. Morgagni hernia: transabdominal or transthoracic approach? Acta Chir. Belgica. 2014. 114:131-5.
- Bawazir O.A., Mahomed A., Fayyad A, Bagaryn E., Bawazir A., Mandora R. Laparoscopic-assisted repair of Morgagni hernia in children. Ann. Pediatr. Surg. 2020. 16:11. https://doi.org/10.1186/s43159-020-00022-2.
- Blood A.G., Whaley Z.L., Kadenhe-Chiweshe A.V., Spigland N.A. Cae report: 19M old boy with Morgagni hernia associated with intestinal maltotation. J. Pediatr. Surg. Case Rep. 2020. 52:101341.
- Cigdem M., Onen A., Okur H., Otcu S. Associated malformations in Morgagni hernia. Pediatr. Surg. Int. 2007. 23911):1101-3.
- Golden J., Barlowa M., Mitchell I. et al. Repair of a bilateral Morgagni hernia in a premature, extremely low birth weight infant. J. Ped. Surg. Case Rep. 2014. 2:145-9.
- Gudumac E., Babuci S., Bârsan A., Malanco S. Hernia congenitală Morgagni asociată cu viciu cardiac și sindromul Down la copil: caz clinic. Arta Medica. 2019. 1(34):57-9.
- Heiwegen K., de Blaauw I., van Ling J., Botden S.M.B.I. Malrotation in congenital diaphragmatic hernia: is really a problem? Eur. J. Pediatr. Surg. 2020. 30(5):434-9.
- Janssens W., Schoneveld M., Allaeys M., De Backer A. Robotic repair pf large Morgagni hernia in an adolescent girl. J. Pediatr. Surg. Case Rep. 2019. 41:51-3.
- Karamustafaoglu Y.A., Kuzucioglu M., Tarladacalisir T., Yoruk Y. Transabdominal subcostal approach in surgical management of Morgagni hernia. Eur. J. Cardio-thor. Surg. 2011. 39:1009-11.
- Kelly K.,Basset D.L. An anatomic reappraisal of the hernia of Morgagni. Surgery. 1964. 55:495-9.î
- Kilic D., Nadir A., Doner E., Kavukcu Ș., Akal M. et al. Transthoracic approach in surgical management of Morgagni hernia. Eur. J. Cardio-thor. Surg. 2001. 20:1016-9.
- Kim J.M., Couluris M., Schnapf B.M. Late-presenting left-sided Morgagni congenital hernia in a 9-year-old male. ISRN Pulmonol. 2011. Art. ID 409252. 4 pag. doi:10.5402/2011/409252.
- Lauriti G., Zani-Ruttenstock E., Catania V.D., Antounians L., Chiesa P.L., Pierro A., Zani A. Open versus laparocopic approach for Morgagni hernia in infants and children: a systematic review and meta-analysis. J. Laparoendosc. & Adv. Surg. Techn. 2018. 888-893. http://doi.org/10.1089/lap.2018.0103.
- Loong T.F.,Kocher H.M. Clinical presentation and operative repair of hernia of Morgagni. Postgrad. Med. J. 2005. 81:41-4. Doi: 10.1136/pgmj.2004.022996.
- Măndrăşescu D., Aprodu G., Munteanu V. Hernia retrosternală (hernia Morgagni) la copil - consideraţii asupra a 2 cazuri. J. de Chirurgie. (Iaşi). 2009. 5(2):187-91.
- Nasr A., Fecteau A. Foramen of Morgagni hernia: presentation and treatment. Thorac. Surg. Clin. 2009. 19:463-8.
- Paris F., Tarazona V., Casilias M., Blasco E., Canto A. et al. Hernia of Morgagni. Thorax. 1973. 28:631-6.
- Rattan K.N., Singh J., Dalal P. Childhood Morgagni hernia: report of two ncases. J. Pediatr. Neonatol. Indiv. Med. 2017. 6(1):e060114. Doi: 10.7363/060114
- Saleh M.E., Mohammed W.S. Morgagni hernia:how to approach! J. Egyptian Soc. Cardio-Thor. Surg. 2017. 25:171-6.
- Slepov O., Kurinnyi S., Pomomarenco O., Migur M. Congenital retrosternal hernias of Morgagni: manifestation and treatment in children. Afr. J. Paediatr. Surg. 2016. 13:57-62.
- Vallee Ph.A. Symptomatic Morgagni hernia misdiagnosed as Chilaiditi sybdrome. West J. Emerg. Med. 2011. 12(1):121-3.
- Wibawanto A.,Habibie Y.A., Arman. Bilateral Morgagni hernia in infant, a rare type in congenital diaphragmatic hernia: a case series. JKS. 2017. 2:93-102.
- Yilmaz M., Isik B., Coban S., Sogutlu G., Ara C. et al. Transabdominal approach in the surgical management of Morgagni hernia. Surg. Today. 2007. 37:9-13.
Corresponding Author
Babuci S.
IMSP Mother and Child Institute “Natalia Gheorghiu” National Scientific-Practical Center for Pediatric Surgery
DOI: https://dx.doi.org/10.18535/jmscr/v9i11.22
