A Case of Morgagni Hernia Combined with an Esophageal Hiatal Hernia Treated by Laparoscopic Surgery

Abstract

A 72-year-old woman presented to our hospital with abdominal pain. A thoracoabdominal CT scan showed a sliding esophageal hiatal hernia and herniation of the stomach, duodenum and transverse colon into the right thoracic cavity, leading to a diagnosis of Morgagni hernia. As she had no prominent strangulation findings, we employed an elective laparoscopic repair through a one-step approach. As for the esophageal hiatal hernia, we performed plication suture of the esophageal hiatus and Toupet fundoplication. For Morgagni hernia in which the transverse colon had prolapsed, we could easily reduce it into the abdomen. The hernia opening was 50 × 60 mm in diameter. We did not resect the hernia sac and repaired with mesh. The patient is doing well without recurrence as of one year after surgery. Morgagni hernia is a rare diaphragmatic hernia in adults, especially the hernia associated with esophageal hiatal hernia is rarer. A laparoscopic approach for both hernias is a beneficial procedure with which we can easily reduce the herniated organs and easily observe the hernia opening. We consider that the approach might be more useful than minimally invasive ones. We report a case of Morgagni hernia with esophageal hiatal hernia, with some bibliographic comments.