A rare case report of Morgagni hernia with organo-axial gastric volvulus and concomitant para-esophageal hernia, repaired laparoscopically in a Septuagenarian

Introduction: Simultaneous occurrence of Morgagni and the para-esophageal hernia is a rare clinical condition with eight case reports in the English-language literature and only four managed laparoscopically. We describe a case of a Septuagenarian patient with Morgagni and concomitant para-esophageal hernia treated laparoscopically. Presentation of a case: A 71-year-old male patient, presented with a onemonth history of regurgitation of acid, retrosternal burning and vomiting after eating. Computed tomography (CT) imaging demonstrated a large anterior diaphragmatic hernia, with herniation of bowel loops and anterosuperior displacement of the gastric antrum along with a grade III Para-esophageal hernia. The patient underwent simultaneous laparoscopic repair of Morgagni and para-esophageal hernia with mesh reinforcement with Nissen’s total antireflux fundoplication. The patient’s postoperative recovery was uneventful. Discussion: A Morgagni hernia is a rare congenital condition consisting of a subcosto-sternal defect in the diaphragm. A para-esophageal hernia is a rare variant of a hiatus hernia. Morgagni and para-esophageal hernia may present with gastric volvulus or incarceration, requiring emergency treatment. Minimally invasive surgery is the preferred treatment, particularly for elderly patients and patients with comorbidities. The laparoscopic operation can provide excellent exposure and repair the hernia defect easily with minimal invasiveness and fewer complications. Conclusion: This case report highlights the co-existence of Morgagni and paraesophageal hernias and validates the feasibility of laparoscopic repair of both hernias simultaneously.

Biography :

Amol Mittal has completed his MBBS in 2014 from Seth G S Medical College and KEM Hospital, Mumbai. Currently, he is pursuing MS General Surgery at B J Medical College and Sassoon General hospitals, Pune.

E-mail: amollucymittal@gmail.com

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