A Case of Morgagni Hernia that Developed after Mixed Esophageal Hiatal Hernia Recurrence

Abstract

A 76-year-old woman was hospitalized because of epigastric pain and vomiting. Severe mixed type hiatal hernia with axial torsion was diagnosed on computed tomography and upper gastrointestinal (GI) series examinations. Therefore, laparoscopic repair was performed with Toupet fundoplication as anti-reflux surgery for severe hiatal hernia. One year and eight months after the initial surgery, she was hospitalized because of acute epigastralgia. Computed tomography showed esophageal hiatal hernia recurrence and a Morgagni hernia, and laparoscopic repair for the recurrent esophageal hiatal hernia was repeated, along with repair of the Morgagni hernia. Approximately 30 mm of the hernia orifice were found on the posterior surface of the sternum, and the greater omentum was impacted. The hernia orifice was closed by suture with mesh reinforcement. The esophageal hiatus opened wide and was closed again by suture. A Morgagni hernia is rare among diaphragmatic hernias, and there are few reports from Japan of a concomitant Morgagni foramen hernia and esophageal hiatal hernia. Thus, this case of Morgagni hernia that developed after mixed esophageal hiatal hernia recurrence is reported along with a review of the relevant literature.