PDF(Pubmed)
Abstract：
We report a case of a Morgagni hernia repaired by primary closure with an extra-abdominal suture. Moreover, we reviewed cases of laparoscopically repaired Morgagni hernia, in which the size of the hernia defect was known, to establish a size criterion for mesh utilization. An 87-year-old woman presented to our hospital with right upper abdominal pain and vomiting. She had no history of abdominal surgery or trauma. Chest radiography and computed tomography (CT) revealed a Morgagni hernia, with the stomach and transverse colon herniated into the right chest cavity. Initially, an endoscopic repair was performed for the herniated stomach due to her age, which was successful. However, she had a recurrence 2 days later, prompting us to perform a semi-emergent laparoscopic surgery. Laparoscopic examination revealed a Morgagni defect, with the omentum, transverse colon, and stomach herniated, with the stomach reduced by pneumoperitoneum. Fortunately, the herniated organs could be easily relocated into the abdomen with no adhesions. The hernia defect measured 6 x 3 cm. We performed primary closure with an extra-abdominal suture. No sac resection was performed. The operation lasted 98 min. Oral intake was initiated on postoperative day 1, and the patient was discharged on postoperative day 3 without complications. Chest radiography and CT scans at 1 month postoperatively showed no recurrence, and the patient remained asymptomatic at the 9-month follow-up examination. According to our review findings, primary closure is an efficient method for small hernia defects (rule of thumb: width, <4 cm; length, <7 cm).
摘要：
我们报告了一例通过腹外缝合进行初次闭合修复的Morgagni疝。此外，我们回顾了腹腔镜修复的Morgagni疝病例，已知疝气缺损的大小，建立网格利用率的尺寸标准。一名87岁的妇女因右上腹部疼痛和呕吐来到我们医院。她没有腹部手术或外伤史。胸部X线摄影和计算机断层扫描（CT）显示Morgagni疝，胃和横结肠突出进入右胸腔。最初，由于她的年龄，对胃疝进行了内窥镜修复，这是成功的。然而,两天后她复发了,促使我们进行半紧急腹腔镜手术。腹腔镜检查显示有Morgagni缺陷,用网膜，横结肠,胃突出，胃因气腹而缩小。幸运的是,突出的器官可以很容易地重新定位到腹部，没有粘连。疝缺损测量为6x3厘米。我们用腹外缝合进行了初次闭合。未进行囊切除。手术持续98分钟。术后第1天开始口服，患者于术后第3天出院，无并发症。术后1个月胸部X线和CT扫描显示无复发，在9个月的随访检查中，患者仍无症状。根据我们的审查结果，原发性闭合是治疗小疝缺损的有效方法(经验法则：宽度，<4厘米；长度，<7厘米）。
