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

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

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 1Nicholas Williams 2

Affiliations expand

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.

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