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Right-sided diaphragmatic rupture after repair of a large Morgagni hernia

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Abstract

We present a case of a combination of primary and secondary diaphragmatic hernia in a 63-year male patient. For progressive dyspnea and palpitations caused by a large and symptomatic Morgagni hernia resulting in a right-sided enterothorax, an open tension-free mesh repair was performed. The postoperative course was complicated by a secondary hepatothorax through a spontaneous rupture of the right diaphragm. Primary mesh repair of the Morgagni hernia, however, proved to be sufficient. This recurrent herniation might be a consequence of (1) preexisting atrophy of the right diaphragm caused by disposition and/or long-term diaphragmatic dysfunction due to the large hernia, combined with (2) further thinning out of the diaphragm by intraoperative hernia sac resection, and (3) postoperative increase of intra-abdominal pressure.

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Fig. 1a–c
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Conflict of interest

All authors declare no conflicts of interest.

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Authors and Affiliations

  1. Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, University of Munich, Campus Grosshadern, Marchioninistr. 15, 81377, Munich, Germany

    T. S. Schiergens, J. G. Koch, P. N. Khalil, K.-W. Jauch & A. Kleespies

  2. Department of Clinical Radiology, University of Munich, Campus Grosshadern, Munich, Germany

    A. Graser

  3. General and Visceral Surgery Unit, Centre Hospitalier Emile Mayrisch (CHEM), Rue Emile Mayrisch, 4005, Esch-sur-Alzette, Luxembourg

    N. P. Zügel

Authors
  1. T. S. Schiergens
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  2. J. G. Koch
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  3. P. N. Khalil
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  4. A. Graser
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  5. N. P. Zügel
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  6. K.-W. Jauch
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  7. A. Kleespies
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Correspondence to T. S. Schiergens.

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Schiergens, T.S., Koch, J.G., Khalil, P.N. et al. Right-sided diaphragmatic rupture after repair of a large Morgagni hernia. Hernia 19, 671–675 (2015). https://doi.org/10.1007/s10029-013-1167-7

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  • DOI: https://doi.org/10.1007/s10029-013-1167-7

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