Transabdominal subcostal approach in surgical management of Morgagni hernia

Objective: Morgagni hernia is an uncommon type of diaphragmatic hernias whose pathophysiology is not clear. We aimed to retrospectively evaluate morbidity, mortality, and treatment outcomes in 13 cases of Morgagni hernia treated with the subcostal approach.

Material and methods: Between 1993 and 2009, 13 patients with Morgagni hernia were operated in our department. Of the 13 patients with a median age of 65 years (range: 13-78), 12 were female. Chest roentgenograms, thorax computed tomography (CT), and barium enema roentgenographic studies were used as diagnostic utilities. The contents of the hernia, as diagnosed with CT and confirmed at surgery, were omentum and colon in all patients.

Results: All the patients were operated electively except one patient on ventilation treatment. Transabdominal repair with the subcostal approach was performed in all patients. There was no operative morbidity and mortality. The median hospital stay was 8 days (range: 6-14 days). There was no recurrence during the follow-up of 48.8 months (1-132 months).

Conclusion: We recommend the transabdominal subcostal approach in patients with Morgagni hernia for surgical exposure, easy repair of the hernia sac, and low morbidity.