Partial obstruction of the inferior vena cava by herniation of the liver through the foramen of Morgagni; a case report.

Abstract

Hedblom (18), in a review of the literature, reported that 75 per cent of patients with untreated congenital diaphragmatic hernia die before the age of one month. The case to be presented here demonstrates a complication, which we have not found previously described, that may influence morbidity and mortality. With the exception of herniation through the foramen of Morgagni, congenital diaphragmatic herniations are four to six times commoner on the left than on the right side (12, 33). Reasons for this pre-ponderance may lie in earlier closure of the right leaf of the diaphragm, greater muscular thickness on the right, and the protective barrier afforded by the liver. The following are the sites of herniation in order of decreasing frequency: (a) foramen of Bochdalek, (b) dome of the diaphragm, (c) esophageal hiatus, (d) foramen of Morgagni, (e) defect produced by partial absence of a hemidiaphragm, usually posteriorly (15). The foramen of Morgagni is a triangular defect normally occurring anteromedially ...