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Management of Morgagni’s Hernia in the Adult Population: A Systematic Review of the Literature

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Morgagni’s hernia (MH) is defined by the protrusion of abdominal viscera through an anterior retrosternal diaphragmatic defect. The objective of this study was to systematically review current literature on MHs in adult population and assess their clinical characteristics and therapeutic approach.


PubMed and Cochrane bibliographical databases were searched (last search: 15th January 2021) for studies concerning MHs.


Inclusion criteria were met by 189 studies that included 310 patients (61.0% females) with an age of 57.37 ± 18.41 (mean ± SD) years. Pulmonary symptoms, abdominal pain, and nausea-vomit were among the most frequent symptomatology. MHs were predominantly right-sided (84.0%), with greater omentum (74.5%) and transverse colon (65.1%) being the most commonly herniated viscera. The majority of cases underwent an open procedure, while 42.3% of patients had a minimally invasive procedure. Abdominal approach was mostly preferred, while a thoracic one was chosen at 20.6% of cases and a thoracoabdominal at 3.2%. Thirty-day postoperative complications were recorded at 29 patients and 30-day mortality was 2.3%.


MH is a rare type of congenital diaphragmatic hernia which rarely manifests in adult population with atypical pulmonary and gastrointestinal symptoms. Surgery is the gold standard for their management. Open surgical approach is preferable in emergency cases, while laparoscopic surgery is favored in elective setting and is associated with shorter hospitalization. Further studies are crucial in order to elucidate etiology and optimal therapeutic approach.

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Authors and Affiliations



Project supervisor: D.S., Conception and design: D.S., S.K., A.B.,Data collection, analysis, and interpretation: I.K., S.K., S.G., N.M., N.K., E.I.K.,Writing the manuscript: I.K., S.K., S.G., N.M., N.K., Critical revision of the manuscript: D.S, S.K., E.I.K., A.B.

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Correspondence to Ioannis Katsaros.

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Conflict of interest

Ioannis Katsaros, Stamatia Katelani, Spyridon Giannopoulos, Nikolaos Machairas, Stylianos Kykalos, Nikolaos Koliakos, Emmanouil I. Kapetanakis, Anargyros Bakopoulos, Dimitrios Schizas declare no conflict of interest.

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Approval from the institutional review board was not required for this type of study.

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This article is a systematic review, and it contains data collected through literature review. It does not include research directly involving human or animal participation.

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For this systematic review, informed consent of individual patients was not necessary.

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Katsaros, I., Katelani, S., Giannopoulos, S. et al. Management of Morgagni’s Hernia in the Adult Population: A Systematic Review of the Literature. World J Surg 45, 3065–3072 (2021).

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