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      Laparoscopic sleeve gastrectomy with concomitant Morgagni hernia repair

      case-report

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          Abstract

          A 36-year-old morbidly obese female with BMI 66 kg/m 2, scheduled for elective laparoscopic sleeve gastrectomy. Prior to the surgery patient had symptoms of mild dyspnea, vague abdominal discomfort. CAT scan of thorax and abdomen revealed a right-sided large morgagni diaphragmatic hernia containing omentum and portion of the transverse colon. Patient elected to undergo Laparoscopic sleeve gastrectomy and concomitant morgagni diaphragmatic hernia repair. The post-operative course was uneventful and the patient was discharged on post-operative Day 2.

          This case is an extremely rare case of super obese patient with Morgagni hernia who desires bariatric surgery and found to have incidental finding of morgagni hernia. This kind of combination can safely undergo concomitant laparoscopic hernia repair with mesh and sleeve gastrectomy.

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          Clinical presentation and operative repair of hernia of Morgagni.

          H Kocher, T. H. Loong (2004)
          A 77 year old woman who presented with an incarcerated hernia of Morgagni was successfully treated without complications. A Medline search (1996 to date) along with cross referencing was done to quantify the number of acute presentations in adults compared to children. Different investigating modalities--for example, lateral chest and abdominal radiography, contrast studies or, in difficult cases, computed tomography or magnetic resonance imaging--can be used to diagnose hernia of Morgagni. The favoured method of repair--laparotomy or laparoscopy--is also discussed. A total of 47 case reports on children and 93 case reports on adults were found. Fourteen percent of children (seven out of 47) presented acutely compared with 12% of adults (12 out of 93). Repair at laparotomy was the method of choice but if uncertain, laparoscopy would be a useful diagnostic tool before attempted repair. Laparoscopic repair was favoured in adults especially in non-acute cases.
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            Surgical treatment of hernia of the foramen of Morgagni.

            O T CLAGETT, T P Comer (1966)
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              Chronic intermittent gastric volvulus within the foramen of Morgagni.

              D Bhasin, B. Nagi, B. Gupta … (1989)
              Hernia through the foramen of Morgagni is uncommon in adults. Chronic gastric volvulus within the foramen of Morgagni is very rare. In this report, we describe a patient who presented with symptoms of gastric outlet obstruction due to chronic intermittent gastric volvulus in the foramen of Morgagni.
              Article 0 comments Cited 5 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Surg Case Rep
                Journal ID (iso-abbrev): J Surg Case Rep
                Journal ID (publisher-id): jscr
                Title: Journal of Surgical Case Reports
                Publisher: Oxford University Press
                ISSN (Electronic): 2042-8812
                Publication date Collection: July 2019
                Publication date (Electronic): 24 July 2019
                Publication date PMC-release: 24 July 2019
                Volume: 2019
                Issue: 7
                Electronic Location Identifier: rjz204
                Affiliations
                [1 ]Bariatric Surgery and Surgical Oncology Consultant, King Saud University, Riyadh, Saudi Arabia
                [2 ]General Surgery Specialist, King Abdulaziz Medical City-Riyadh, Saudi Arabia
                [3 ]General Surgery Specialist, King Saud Medical City-Riyadh, Saudi Arabia
                [4 ]Bariatric Surgery Department, Dr Sulaiman Al Habib Hospital, Riyadh, KSA
                Author notes
                Correspondence address. Awadh Alqahtani, MD,FRCSC, Bariatric Surgery and Surgical Oncology Consultant, King Saud University, Riyadh, Saudi Arabia. Tel: +00966552894444; E-mail: dr_aq1@ 123456yahoo.com
                Article
                Publisher ID: rjz204
                DOI: 10.1093/jscr/rjz204
                PMC ID: 6656320
                SO-VID: f5b55f87-8585-49b0-b619-1d937e482615
                Copyright © Published by Oxford University Press and JSCR Publishing Ltd. All rights reserved. © The Author(s) 2019.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@ 123456oup.com

                History
                Date received : 13 May 2019
                Date accepted : 19 June 2019
                Page count
                Pages: 2
                Categories
                Subject: Case Report

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