Jurnalul de chirurgie
Aparitie trimestriala in a doua luna a trimestrului
Published quarterly in the second month of the quarter ISSN: 1584 - 9341
Vol.10 Nr.3 - Iulie-Septembrie 2014 | miercuri, 20 ianuarie 2021
ISSN: 1584 - 9341 Vol.10 No.3 - July-September 2014
English| Romana
Creditare EMC Colegiul Medicilor
Syndicate
HERNIA MORGAGNI – ABORD LAPAROSCOPIC Şt.O. Georgescu (1,2), Paula Popa (2), Felicia Crumpei (3), Cristina Cijevschi Prelipcean (4) 1) Departamentul de chirurgie, Universitatea de Medicină şi Farmacie „Gr.T. Popa” Iaşi 2) Clinica a II-a Chirurgie Spitalul „Sf. Spiridon” Iaşi 3) Departamentul de radiologie şi imagistică medicală, Spitalul „Sf. Spiridon” Iaşi 4) Institutul de Gastroenterologie şi Hepatologie, Spitalul „Sf. Spiridon” Iaşi, Universitatea de Medicină şi Farmacie „Gr.T. Popa” Iaşi Jurnalul de chirurgie (Iaşi). 2013; 9(3): 269-274. Full text: Format PDF (Română/Romanian)
Abstract:
INTRODUCTION: Morgagni hernia is due to a diaphragmatic defect, retrosternal congenital hernia being a rare form of hernie. The diagnosis is usually in childhood but there are cases that are found in adult or as a intraoperative surprise. The condition is asymptomatic or has nonspecific clinical manifestations or clinical dressing of often occlusive complications. The diagnosis is established by Rx thoracic imaging, barium enema or computed tomography (CT) eso-gastro-duodenal passage. Treatment consists of reducing the hernia with or without dissection and resection of the hernia sac and diaphragmatic defect closure by suture the fascia endotoracica retrosternal and retrocostala or rectus abdominis sheath or plastic bag. CASE PRESENTATION: We present a case of a 49 years old woman admitted in our department for an insidious onset, several months ago, with postprandial upper abdominal pain, flatulence and nausea. CT scan revealed a mass of 95 / 130 / 80 mm, narrowly defined with homogeneous structure and negative densities (fat) in the lower and middle mediastinum, outlining opacity described in cardiofrenic sinus radiography. The aspect was characteristic for a Morgagni hiatus hernia. Exploratory laparoscopy was performed using a 30º laparoscope inserted through a 10 mm supraombilical trocar; it revealed the parietal defect (Morgagni hernia) and the herniation of greater omentum. Two additional 5 mm trocars are then inserted; the escaped great omentum was reintegrated and the parietal defect was laparoscopically sutured. To note, the peritoneal hernia sac was abandoned. Postoperative course was uneventful. A review of the literature data was also performed. CONCLUSION: Minimally invasive surgery is feasible, safe and tends to become “gold standard” therapeutic approach for the treatment of Morgagni hernia.
| Romana 
