Gallbladder Torsion with Incarceration into the Foramen of Morgagni

Abstract

A 91-year-old woman presented to our hospital with difficulty moving and loss of consciousness. Although she did not complain of abdominal pain, laboratory tests indicated an ongoing inflammatory response with increased lactate levels. An enhanced abdominal computed tomography scan revealed an enlarged gallbladder that was incarcerated into the foramen of Morgagni. The diagnosis was gangrenous cholecystitis with incarceration into the foramen of Morgagni and an emergency open laparotomy was performed. During the operation, incarceration of the gallbladder into the foramen of Morgagni was observed. Surprisingly, the gallbladder was twisted at the neck and the serosal surface showed black discoloration. The gallbladder was removed and a cholecystectomy was performed. The hernial orifice was closed by suturing the foramen of Morgagni. The postoperative course was uneventful, and the patient was transferred to another hospital on postoperative day 21. Morgagni hernia is a relatively rare type of hernia, accounting for only 3% of diaphragmatic hernias. Incarceration of the gallbladder into the foramen of Morgagni is even more rare. We report a case of an elderly woman with a Morgagni hernia complicated by gallbladder torsion.