Int J Surg Case Rep

. 2022 Feb 24;93:106846. doi: 10.1016/j.ijscr.2022.106846. Online ahead of print. https://pubmed.ncbi.nlm.nih.gov/35306334/

Laparoscopic repair of an incarcerated Morgagni Hernia in a COVID-19-positive patient: A video case report

Abdolreza Pazouki ¹, Fatemeh Mohammadyari ², Seyed Adel Maleknia ³, Faridadin Ebrahimi Meymand ³, Barmak Gholizadeh ⁴Affiliations expand

• PMID: 35306334
• PMCID: PMC8941208
• DOI: 10.1016/j.ijscr.2022.106846

Free PMC article

Abstract

Introduction: Morgagni Hernia (MH) is a type of congenital diaphragmatic hernia (CDH). CDH is a diaphragmatic discontinuity that permits abdominal viscera to herniate into the chest during development. It does not only occur in early childhood but also has been reported in adults. The most prevalent clinical sign of MH is respiratory disorder of all ages.

Case presentation: An elderly woman with a known history of diabetes, ischemic heart disease, hypertension, and constipation presented to us with increased abdominal pain. Besides, her PCR test results were positive for COVID-19. She underwent diagnostic laparoscopy surgery. The incision was closed with an intracorporeal suture, and then dual mesh was fixed to diaphragmatic wall. The postoperative progress was satisfactory two weeks after surgery. Based on a negative PCR test, the patient was discharged from the hospital.

Discussion: The foramina of Morgagni is a defect in the costosternal trigons produced by a lack of anterior pleuroperitoneal membrane muscularization. Although gastrointestinal symptoms and cardiorespiratory discomfort are typically connected with the diagnosis and treatment of MH in youngsters, there are a few middle-aged people who, like our case, develop symptoms suddenly. Albeit a paradigm change in the 21st century deems less invasive laparoscopic surgery to be the treatment of choice, open surgical procedures via a trans-thoracic or trans-abdominal route are still used.

Conclusion: MH is indeed uncommon in adults, but in patients with an acute onset of intestinal obstruction, the possibility of MH should be in mind. It can be fatal if it is misdiagnosed.

Keywords: COVID-19; Case report; Diagnostic laparoscopy; Dual mesh; Elderly woman; Morgagni Hernia.

Copyright © 2022. Published by Elsevier Ltd.