J Surg Case Rep

. 2023 Jan 10;2023(1):rjac614.

 doi: 10.1093/jscr/rjac614. eCollection 2023 Jan. https://pubmed.ncbi.nlm.nih.gov/36636647/

Non-operative management of a large Morgagni hernia-an alternative approach?

Jack Peter Archer ¹, Nicholas Williams ²

Affiliations expand

• PMID: 36636647
• PMCID: PMC9831640
• DOI: 10.1093/jscr/rjac614

Free PMC article

Abstract

Morgagni’s hernia (MH) is a congenital diaphragmatic hernia with a small percentage of cases diagnosed in adulthood. The average age of diagnosis is 57 years, with 61% being female and 10-28% being asymptomatic. It is common practice to complete surgical repair of MH regardless of symptomology or size of the defect despite a paucity of evidence. This paper highlights the potential for non-operative management as a reasonable treatment option in large asymptomatic MH. A female in her 40s was referred following an abnormal spirometry result as a part of a routine pre-employment check. She subsequently had imaging, which showed a large MH with abdominal contents within the thoracic cavity. Following discussion at a multidisciplinary team meeting, it was decided that the risk of perioperative morbidity likely exceeded the risk of strangulation while asymptomatic, and thus surveillance was recommended.

Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2023.