In a world full of diseases, hernia is one of the common illnesses that is mostly found in adults. It is developed in a body when any body part or internal organ sticks to the wall of tissue or muscle. Morgagni hernia is one of the four types of innate diaphragmatic hernia. It is rarer than all the other types of an innate diaphragmatic hernia and is known as a defect present by birth in a body, which starts to become visible in adulthood.
To get yourself familiar with all the necessary information regarding this type of hernia, you must continue to read this article thoroughly. All the relevant information regarding this disease is mentioned below.
What is Morgagni Hernia?
Morgagni hernia is a common type of diaphragmatic hernia, in which the contents of the bowel herniates through an asymmetrical opening into the chest cavity. In other words, Morgagni hernia is a defect, which is present in an individual by birth and begins to be visible in adulthood. The weakness in the diaphragm by birth is usually small, but as the patient becomes older and older, this defect expands subordinate to increased intra-abdominal pressure. It is usually symptomless. Morgagni hernia has the utmost rare symptomatic adult cases. Most of them are commonly asymptomatic cases and are found accidentally during other diagnostic tests.
Morgagni Hernia Symptoms
Usually, the patients of Morgagni’s hernia are asymptomatic at an early age, as well as in adulthood. Rare cases of Morgagni’s hernia are symptomatic. The rare symptomatic adult cases which experience the symptoms of this disease are mentioned below:
- Indistinct respiratory system (cough, shortness of breath, ejecting mucus from lungs by coughing and spitting).
- Nausea and vomiting.
- Pain after eating food.
- Pain in subcostal areas like (the upper abdomen, in the lower portion of ribs, and both sides of the waist).
- Extreme cramps.
- Lack of faeces or constipation.
- Intestinal obstruction.
These are the signs that help in diagnosing Morgagni’s hernia in a person. But when the symptoms are not observable, then conventional radiography is used to diagnose this disease in a person.
Morgagni Hernia Causes
It is not necessary that there must be some cause of a disease. Some diseases and syndromes are by birth in a person. Similarly, Morgagni hernia is a congenital disease. But some conditions such as pregnancy, constant cough for a long time, constipation or lack of faeces, and obesity, etc., these conditions are the source of increasing the intra-abdominal pressure, which leads to the development of such disease. This disease includes the failure of the diaphragm, coastal arches, and also the failure of the fusion of the septum transversum.
Morgagni Hernia Treatment
Surgeons recommend that Morgagni hernia should be treated surgically. There are two types of surgeries that are used to treat the Morgagni hernia mentioned below:
- Transabdominal (laparoscopic or open)
- Transthoracic (thoracoscopic or open)
This approach allows the uncomplicated depletion of the contents of hernia, assessment of the contralateral diaphragm for extra defects and, the evaluation and repair of intra abdominal pathology. According to the research, it is revealed that, out of 46 cases of transabdominal or laparoscopic, in 29% of cases, the defect is closed primarily while in 7% of cases, a mesh is placed for bridging. For large-sized defects, a mesh is used to provide a stress-free and smooth surface. This transabdominal repair is considered the gold-standard treatment for the patients of Morgagni’s hernia. The laparoscopic approach prevents deadly complications and is also best for the elderly asymptomatic patients as it has very minimum side effects.
In this type of surgery, posterolateral right thoracotomy is made through the six spaces between both ribs. This technique is usually applied to those patients who have this defect present on their right side of the body, because the hernia sac of the pleural structures, mediastinal, and pericardium are dissected quite easily. Also, the viscera of the abdomen reduces safely. It depends on the condition of the patient, whether the hernia sac must be excised or not. After this whole procedure, the treated area is then sewed with 0-propylene or 0-silk stitches. The one disadvantage of this approach is that due to the inability to see on the left side, there is a risk of missing bilateral defects.
In these two approaches, the first one is preferable, as it has a minimum rate of side effects and more chances of survival, but it also depends on the patient’s condition that which kind of surgery must be used.