Abstract
An 86-year-old woman was diagnosed with a Morgagni foramen hernia combined with an esophageal hiatal hernia 3.5 years ago based on an abnormal abdominal roentgenogram. A wait-and-see approach was taken because she had no symptoms, and computed tomography (CT) revealed a hernia of the greater omentum protruding into the right thoracic cavity through the foramen of Morgagni. This time, she complained of difficulty in breathing on exertion, and was referred to our hospital. Surgery was performed because CT demonstrated growth of the hernial orifice and content. A laparoscopic operation was planned. First, the esophageal hiatal hernia was treated, followed by the Morgagni foramen hernia. The esophageal hiatal hernia was of the sliding type, and about 5 cm in diameter. The hiatus was closed with direct sutures and recovered using composite mesh. Next, Nissen-type fundoplication was performed. The Morgagni foramen hernia, which had an orifice of about 4 cm in diameter and contained the transverse colon, was repaired with composite mesh without direct suturing of the orifice. The postoperative course was uneventful. Laparoscopic repair of Morgagni foramen hernia and esophageal hiatal hernia is a safe procedure.
