Morgagni-Larrey hernia is a very rare congenital diaphragmatic hernia, with an incidence of 2-5% of all diaphragmatic hernias and is usually diagnosed incidentally in asymptomatic adults. In this case report, we present a 55-year-old man with intestinal obstruction-like symptoms, diagnosed as a large Morgagni-Larrey hernia. He underwent primary hernia repair using a transabdominal approach with a laparoscopic technique.
Morgagni’s hernia is a rare congenital disorder, usually asymptomatic, but may cause respiratory or gastrointestinal symptoms. The authors describe the case of a male patient 55years old with Down syndrome treated for years at home for respiratory failure and recurrent bronchopneumonia. The patient arrives in DEA with vomiting, fever and weight loss. The patient was then subjected to chest x-ray which demonstrated a marked lifting of the right hemidiaphragm with ascent of the intestinal loops, the heart area was apparently within normal limits and thoracic aorta was regular for age.
Subsequently, the patient underwent a chest and abdomen CT with visualization of a Morgagni-Larrey hernia with complete herniation of the hepatic colonic flexure and peritoneal fat, omentum and part of the gastric body above the right hemidiaphragm and secondary compression of the pulmonary parenchyma with disventilatory manifestations.
In the years prior to hospitalization, the patient had undergone chest X-rays which had always misunderstood the hernial defect, finding only the rise of the awake hemidiaphragm and the compression of the pulmunary parenchyma with partial dislocation to the left of the mediastinum.
The patient then underwent laparoscopic diaphragmatic repair.