Skip to main content


Log in

Clinical and Radiologic Evaluation of Foramen of Morgagni Hernias and the Transthoracic Approach

  • Published:
World Journal of Surgery Aims and scope Submit manuscript


The limited number of publications on repair of the foramen of Morgagni hernia concentrates mainly on the laparotomy approach. We present our experience with the transthoracic approach. Patients who were diagnosed as having a foramen of Morgagni hernia and were operated on via the transthoracic approach between December 1991 and June 2004 are reviewed retrospectively for their age, sex, presenting symptoms, and diagnostic and surgical procedures. Surgical repair was carried out via the transthoracic approach in all cases. Of the 24 patients who underwent transthoracic diaphragmatic repair of the defect, 16 were women and 8 were men, with an overall mean age of 55.1 years (range 42–69 years). In most cases the defect was on the right side; there was only one case of a left-sided defect. The most common presenting symptoms were dyspnea and gastrointestinal discomfort; five (20.8%) patients were asymptomatic. In 21 cases (87.5%) the diagnoses were established radiologically. The defect was accessed surgically via a posterolateral thoracotomy. No postoperative morbidity or mortality was observed. The mean follow-up was 8.3 years (14 months to 14 years), and no recurrence was noted. As important as the surgical repair of the foramen of Morgagni hernia itself is selection of the surgical approach so adhesions of the hernial sac from the surrounding tissues in the thoracic cavity are easily released. The transthoracic approach is amenable to safe primary repair of the defect and the release of adhesions, even in elderly and obese patients, in whom adhesions may be excessive.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Figure 1
Figure 2
Figure 3
Figure 4

Similar content being viewed by others


  1. Comer TP, Clagett OT. Surgical treatment of hernia of the foramen of Morgagni. J Thorac Cardiovasc Surg 1996;52:461–468

    Google Scholar 

  2. Minneci PC, Deans KJ, Kim P, et al. Foramen of Morgagni hernia: changes in diagnosis and treatment. Ann Thorac Surg 2004;77:1956–1959

    Article  PubMed  Google Scholar 

  3. Kilic D, Nadir A, Doner E, et al. Transthoracic approach in surgical management of Morgagni hernia. Eur J Cardiothorac Surg 2001;20:1016–1019

    Article  PubMed  CAS  Google Scholar 

  4. Federico JA, Ponn RB. Foramen of Morgagni hernia. In Shields TW, LoCicero J III, Ponn RB, editors. General thoracic surgery, Philadelphia, Lippincott Williams & Wilkins, 2000 647–659

    Google Scholar 

  5. Hussong RL Jr, Landreneau RJ, Cole FH Jr. Diagnosis and repair of a Morgagni hernia with video-assisted thoracic surgery. Ann Thorac Surg 2000;:1997–63:1474–1475

    Google Scholar 

  6. Reynolds M. Congenital posterolateral diaphragmatic hernias and other less common hernias of the diaphragm in infants and children. In: Shields TW, LoCicero J III, Ponn RB, editors. General thoracic surgery, Philadelphia, Lippincott Williams & Wilkins, 2000;637–646

    Google Scholar 

  7. Berman L, Stringer D, Ein SH, et al. The late-presenting pediatric Morgagni hernia: a benign condition. J Pediatr Surg 1989;24:970–972

    PubMed  CAS  Google Scholar 

  8. Valases C, Sills C. Anterior diaphragmatic hernia (hernia of Morgagni). N J Med 1998;85:603–605

    Google Scholar 

  9. Thomas TV. Subcostosternal diaphragmatic hernia. J Thorac Cardiovasc Surg 1972;63:279–283

    PubMed  CAS  Google Scholar 

  10. Fagelman D, Caridi JG. CT diagnosis of hernia of Morgagni. Gastrointest Radiol 1984;9:153–155

    Article  PubMed  CAS  Google Scholar 

  11. Yildirim B, Ozaras R, Tahan V, et al. Diaphragmatic Morgagni hernia in adulthood: correct preoperative diagnosis is possible with newer imaging techniques. Acta Chir Belg 2000;100:31–33

    PubMed  CAS  Google Scholar 

  12. Kamiya N, Yokoi K, Miyazawa N, et al. Morgagni hernia diagnosed by MRI. Surg Today 1996;26:446–448

    Article  PubMed  CAS  Google Scholar 

  13. Yeager BA, Guglielmi GE, Schiebler ML, et al. Magnetic resonance imaging of Morgagni hernia. Gastrointest Radiol 1987;12:296–298

    Article  PubMed  CAS  Google Scholar 

  14. Bhasin DK, Nagi B, Gupta NM, et al. Chronic intermittent gastric volvulus within the foramen of Morgagni. Am J Gastroentrol 1989;84:1106–1108

    CAS  Google Scholar 

  15. Moghissi K. Operation for repair of obstructed substernocostal (Morgagni) hernia. Thorax 1981;36:392–394

    Article  PubMed  CAS  Google Scholar 

  16. Kurkcuoglu IC, Eroglu A, Karaoglanoglu N, et al. Diagnosis and surgical treatment of Morgagni hernia: report of three cases. Surg Today 2003;33:525–528

    PubMed  Google Scholar 

  17. Newman L, Eubanks S, Bridges WM, et al. Laparoscopic diagnosis and treatment of Morgagni hernia. Surg Laporosc Endosc 1995;5:27–31

    Google Scholar 

  18. Becmeur F, Chevalier KI, Frey G, et al. Laparoscopic treatment of a diaphragmatic hernia through the foramen of Morgagni in children: a case report and review of eleven cases reported in the adult literature. Ann Chir 1998;52:1060–1063

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Mehmet Sırmalı MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sırmalı, M., Türüt, H., Gezer, S. et al. Clinical and Radiologic Evaluation of Foramen of Morgagni Hernias and the Transthoracic Approach. World J. Surg. 29, 1520–1524 (2005).

Download citation

  • Published:

  • Issue Date:

  • DOI: