Abstract
BackgroundMorgagni hernia (MH) is a rare diaphragmatic hernia with nonspecific symptoms and variable presentation. MH is managed surgically via laparotomy or a thoracotomy. Recently, laparoscopy was described for the repair of MH. The objective of this study is to report our institutional experience in laparoscopic repair of MH in infants and children.ResultsTwenty-five patients with MH were included; 17 of them were males (68%). Their median age at the time of diagnosis was 18 months. Sixteen patients (64%) presented with a recurrent chest infection. MH was on the right side in 8 patients, left side in 2, and central in 12, and 3 patients had bilateral hernias. Eleven patients (44%) had congenital heart disease, 10 (40%) had Down’s syndrome, and 2 (4%) had malrotation of the bowel. The median size of the hernia defect was 3 × 3.5 cm2, and the most common content was the colon (n = 19). One patient with Down’s syndrome developed recurrence and underwent open repair. The median operative time was 95 min. The postoperative recovery was uneventful, and the average postoperative stay was 3 days. The median follow-up was 4.5 years, and there was no reported mortality.ConclusionsMorgagni hernia is commonly associated with other congenital anomalies. Laparoscopic repair of Morgagni hernia in children is feasible with excellent postoperative outcomes.
Highlights
Morgagni hernia (MH) is a rare diaphragmatic hernia with nonspecific symptoms and variable presentation
The diaphragmatic defect is congenital in origin; it could be acquired as an incisional hernia after median sternotomy
Twenty-five patients with Morgagni hernia were presented to our hospital during the study period
Summary
Morgagni hernia (MH) is a rare diaphragmatic hernia with nonspecific symptoms and variable presentation. The objective of this study is to report our institutional experience in laparoscopic repair of MH in infants and children. Morgagni’s hernia (MH) is a retrosternal herniation of the abdominal contents through a diaphragmatic defect, and it presents 3–5% of all diaphragmatic hernias [1]. The diaphragmatic defect is congenital in origin; it could be acquired as an incisional hernia after median sternotomy. In the pediatric age group, the presentation of congenital Morgagni’s hernia is variable. The standard treatment of MH is surgical closure of the defect via laparotomy or thoracotomy. Various laparoscopic techniques for the repair, including a primary closure of the defect with intracorporeal sutures, stapler, or a mesh, have been proposed [3]. Minimal invasive repair of MH has achieved satisfactory results with less trauma and earlier return to physical activity; the rate of complications is still high [2, Bawazir et al Annals of Pediatric Surgery (2020) 16:11
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