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A Morgagni hernia is a rare form of congenital diaphragmatic hernia (CDH) observed in fewer than one in 20 patients with CDH. It is one of four possible types and is often asymptomatic, only being diagnosed later in life as part of evaluation and treatment for unrelated medical issues. In some cases, the defect in the patient's diaphragm is larger and causes complications at or near birth, requiring surgical intervention to stabilize the patient and address the problem.
In a patient with a Morgagni hernia, part of the abdominal viscera herniate through small openings near the front of the diaphragm known as foramina of Morgagni. Defects on the right side are more common, but they can also occur on the left. On a medical imaging study, a small protrusion of material can be seen in the thorax. The concern with this particular congenital condition is that the hernia may become strangulated, cutting off the blood supply to the tissue and allowing it to die, or the size may increase, putting pressure on the contents of the thorax.
Symptomatic Morgagni hernia cases usually involve irregular heartbeat, difficulty breathing, and gastrointestinal discomfort. These symptoms may appear immediately after birth if the defect is large, or later in life in other cases. Medical imaging studies will reveal the nature and extent of the defect, allowing a doctor to make a decision about treatment.
If treatment is required, it usually involves reducing the hernia, moving the contents of the abdomen back to where they belong, and then patching the hole to prevent a herniation in the future. Surgical mesh is available for this purpose, allowing people to create a firm barrier across the diaphragm. A patient with a Morgagni hernia should experience a complete recovery and a substantial improvement in comfort levels after the surgery, as the pressure inside the thorax will be relieved.
Sometimes this type of CDH is spotted as an incidental finding on medical imaging studies conducted for another reason. It may be pointed out as a feature of interest and noted in a chart, but no additional actions may be needed. If the patient starts to experience complications in the future, the Morgagni hernia can be reassessed to see if problems have developed, and the possibility of surgery can be explored. Doctors will generally not recommend surgical treatment unless they think the patient is likely to experience an improvement in a medical issue or there is a concern about strangulation of the hernia.
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