2023 Volume 56 Issue 4 Pages 229-238
Parasternal diaphragmatic hernia (PDH) (also known as Morgagni-Larrey hernia) is a relatively rare disease. Here, we report a case of PDH and review 655 published cases of PDH in adults. An 83-year-old woman with kyphosis was admitted to our hospital with vomiting and severe dehydration. She was diagnosed with PDH with incarceration of the distal stomach and duodenum by diagnostic imaging. After reduction, the PDH was surgically repaired using the laparoscopic tension-free method with Ventralight® mesh. This mesh is flexible and translucent, and therefore, was easy to use. A sac seroma was diagnosed postoperatively by CT; however, this resolved with conservative treatment (observation only). The postoperative course was uneventful and the patient was discharged. Female sex and obesity are predisposing factors for PDH. Historically, in cases in which PDH was misdiagnosed as a thoracic tumor, thoracotomy was chosen as the treatment method. Increased use of CT has improved diagnostic accuracy, and selection of laparoscopic surgery is increasingly common. The primary repair method, reinforcing method, and tension-free method have all been used to repair PDH, but the tension-free method is becoming more common. Using these methods, the rates of postoperative mortality and hernia recurrence are less than 1%, indicating good outcomes.
