Morgagni Hernia with Intestinal Obstruction in Adults with Diaphragmatic Plasty: Case Report
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Abstract
Morgagni hernia is a rare form of congenital diaphragmatic hernia that represents 2% to 5% of all diaphragmatic hernias, with an estimated incidence of 1 in 2000 to 1 in 5000 live births (1,2). It was described by Giovanni Battista Morgagni in 1769 (3). It results from the failure of fusion of the anterior pleuroperitoneal membrane with the sternum and costal cartilages (4). The contents of the hernia sac may include omentum, colon, stomach, and even liver (5). The diagnosis is primarily made through computed tomography (6).
A 64-year-old female patient with a history of arterial hypertension and diabetes mellitus presented with a clinical course of six days characterized by abdominal distension, right hypochondrium pain, nausea, vomiting, and decreased bowel transit. Physical examination revealed abdominal distension with tympanism and tenderness on deep palpation in the right hypochondrium. CT confirmed an anterior right diaphragmatic defect measuring 32 mm, with herniation of abdominal fat and the hepatic angle of the colon, which was compressed causing intestinal obstruction. Exploratory laparotomy was performed, identifying a Morgagni hernia with a 4 × 3 cm defect and a hernia sac measuring 10 × 5 cm containing transverse colon and necrotic omentum. Necrotic omentum resection, reduction of the herniated contents, sac ligation, and primary closure of the diaphragmatic defect were performed.
A comprehensive review of 17 indexed articles published between 2020 and 2025 was conducted, consolidating information on epidemiology, clinical presentation, diagnostic methods, and surgical management of this pathology. It is concluded that surgical repair should be indicated in all cases, preferring the laparoscopic approach when possible, using mesh in defects greater than 4 cm, and individualizing sac resection (8–17). This article provides an updated, evidence-based perspective on the management of Morgagni hernia in adults
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References
I. Delgado MDPG, López LR, Velasco SM, Galeano PF, Santoyo JS. Stenosing colon neoplasia causing colonic perforation in a patient with Morgagni-Larrey’s hernia. Journal of Clinical Images and Medical Case Reports. 2021;2(3):1147.
II. Cartwright T, Charoenmins P, Nelson C, Faustino J, Akhtar SJ. Morgagni hernia presenting as constipation in the postsurgical patient: A case report. International Journal of Abdominal Wall Hernia Surgery. 2023;6(1):44–47.
III. Albasheer O, Khan AM, Fadul I, et al. Giant Morgagni hernia with transthoracic herniation of the left liver lobe and transverse colon: a case report. Journal of Medical Case Reports. 2023;17:165.
IV. Hasegawa M, Sanmoto Y, Kinuta S. Laparoscopic repair of Morgagni hernia by primary closure with extra-abdominal suture: a case report and review of the literature. Pan African Medical Journal. 2024;47:150.
V. Sasaki N, Nakamura H, Matsumoto J, et al. Incarcerated Larrey hernia with small bowel obstruction: A case report. International Journal of Surgery Case Reports. 2023;104:107968.
VI. Lindsey J, Smith R, Taylor E. Incarcerated Morgagni Hernia Presenting after Robotic-Assisted Laparoscopic Total Abdominal Hysterectomy and Bilateral Salpingo-Oophorectomy. ACS Case Reviews. 2023;4(3).
VII. Slimi Y, Bouzidi A, Ben Hassen W, et al. Previously unrecognized Morgagni’s hernia presenting with bowel obstruction: a rare case report. International Journal of Surgery Global Health. 2024;7:e0444.
VIII. Hernández C, Ramírez R, Paredes P, et al. Diagnóstico y tratamiento quirúrgico de la hernia de Morgagni en el adulto. Cirugía General de México. 2022;44(2):99–104.
IX. Gómez R, Torres F, Martínez G, et al. Hernia de Morgagni: revisión de casos y abordaje laparoscópico. Revista Española de Cirugía. 2021;99(4):225–231.
X. Patel H, Sharma M, Agarwal A. Morgagni Hernia in Adults: Diagnostic Challenges and Surgical Management. Surgical Endoscopy. 2022;36(9):6500–6508.
XI. Wang F, Zhao J, Liu X, et al. Imaging Modalities in the Diagnosis of Morgagni Hernia. European Journal of Radiology. 2022;147:110074.
XII. Lee J, Kim K, Park S, et al. Laparoscopic Repair of Morgagni Hernia: Experience in a Tertiary Center. International Journal of Surgery. 2020;76:60–66.
XIII. Singh A, Verma R, Gupta N. Morgagni Hernia: A Rare Diagnosis in Adults. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2023;33(7):772–778.
XIV. Kunitsky A, Mansoor A, Sauerbeck T, Lang D, Pastor R. Morgagni Hernia: Management in a 77-Year-Old Female With a Robotic Approach. Cureus. 2025;17(3):e81531.
XV. Yu G, Zhao Y, Chen X. Previously undiagnosed Morgagni hernia with bowel perforation detected during repeat screening colonoscopy: A case report. International Journal of Surgery Case Reports. 2023;102:107844.
XVI. Kumar S, Prasad M, Singh D. Bilateral incarcerated Morgagni hernia with bowel obstruction: A case report. International Journal of Surgery Case Reports. 2023;103:107867.
XVII. Bhatnagar A, Gupta R, Kakar A. Perforated Appendicitis and Bowel Incarceration within Morgagni Hernia: A Case Report. International Journal of Surgery Case Reports. 2023;101:107832.