Morgagni Hernia Repair in Adults: A Single-Center Experience in Spanish Population.

Abstract

Introduction: Morgagni hernia (MH) is a rare congenital disorder, especially in adults, accounting for 2%-4% of all congenital diaphragmatic hernias. Materials and Methods: Retrospective review of all patients who underwent surgical repair of MH at our center from 1991 to 2022. A descriptive analysis was performed. Results: Eighteen patients presented with MH, of whom 11 (61.11%) were female, with a median age of 67.60 (IQR 50.25-84.50) years old. Six (33.33%) were asymptomatic and 12 (66.67%) presented with symptoms, being dyspnea (4; 33.33%) the most common. On the group of symptomatic patients, the computed tomography scan (8; 66.67%) was the most frequent diagnostic test. Whereas in the asymptomatic group, 5 patients (83.33%) were diagnosed intraoperatively, during surgery for other reasons. MH was mostly located on the right (16; 88.89%). Hernia contents included omentum and colon (10; 55.56%), omentum (5; 27.78%), and stomach (3; 16.67%). All patients underwent surgical repair, needing in 3 cases (16.67%) emergency surgery. Surgical approaches included 10 laparoscopies (55.56%), 7 laparotomies (38.89%), and 1 thoracotomy (5.55%). Repair was generally performed whether by primary closure in 8 patients (44.4%) or by mesh implantation in 10 (55.56%). The median hospital stay was 6 days (IQR 3-10). Three patients presented complications (17.65%): urinary tract infection (1 patient), intra-abdominal collection (1 patient), and the last 1 presented with renal failure and pneumonia. The median follow-up was 74 months (IQR 4.5-130). No recurrence was described. Conclusions: MH is a rare condition in the adult population. In our series most patients presented with symptoms. The gold standard treatment is surgical repair, being the laparoscopic approach the most frequent. The complications rate was relatively low and no recurrence was described in our study.