Misimi S, Shurlani A, Nikolovski A. Incidentally Diagnosed Large Asymptomatic Morgagni Hernia in Adult Male Patient.
Eur J Case Rep Intern Med 2023;
10:004047. [PMID:
37789983 PMCID:
PMC10545154 DOI:
10.12890/2023_004047]
[Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 08/16/2023] [Indexed: 10/05/2023] Open
Abstract
Background
Congenital diaphragmatic hernias are rare congenital defects resulting in abdominal organ protrusion into the thoracic cavity; they mainly present with pulmonary or gastrointestinal symptoms. Although congenital and discovered in utero or in early childhood, they can be asymptomatic for a long time and even remain asymptomatic despite the growing hernia sac dimensions and the hernia sac contents.
Case description
We present a case of a 58-year-old patient with incidentally diagnosed Morgagni hernia during the COVID-19 pandemic following a computerised tomography (CT) scan of the chest. He presented without any symptoms related to the existence of the hernia. Another CT scan was performed 20 months after the initial diagnosis to evaluate the progression of the hernia. The patient refused the offered surgery due to the absence of symptoms.
Discussion
A Morgagni hernia is usually discovered during pregnancy or in early childhood, but sometimes can be asymptomatic for years. Main symptoms originate from the respiratory and gastrointestinal system.
Conclusion
Due to the refusal of surgery, we were able to follow the CT scan enlargement progression of patients' hernia over a 20-month period.
LEARNING POINTS
Congenital diaphragmatic Morgagni hernias can remain undiscovered for a long period of time.Despite the usual clinical presentation with pulmonary and/or gastrointestinal symptoms, it can be asymptomatic in some patients.Surgery is the recommended treatment for a Morgagni hernia (via the thoracic or abdominal access).
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