Colonic Dyspnea and the Morgagni Hernia: A Rare Adult Diagnosis
Related: Unusual Congenital Pulmonary Anomaly in an Adult Patient With Dyspnea
There is some controversy about the management of the hernia sac, with about 69% of surgeons choosing not to excise the sac due to concerns of intrathoracic or pericardial injury.7 In a separate study, 36 patients were evaluated retrospectively, and the hernia sac was not resected in any of the patients, with long-term follow-up revealing no evidence of recurrence.6
Conclusion
To allow for early intervention and avoidance of potentially life-threatening volvulus/strangulation, the medical practitioner has to be aware of this rare diagnosis when performing a workup for vague pulmonary and abdominal symptoms as described here. Disagreement exists over the method of repair and management of the hernia sac as well as the need for mesh buttressing of the defect. A well-planned surgical approach individualized to the patient’s anatomy, surgeon’s expertise, and hernia defect size will provide the best possible outcome with a low operative morbidity.
Author disclosures
The authors report no actual or potential conflicts of interest with regard to this article.
Disclaimer
The opinions expressed herein are those of the authors and do not necessarily reflect those of Federal Practitioner, Frontline Medical Communications Inc., the U.S. Government, or any of its agencies. This article may discuss unlabeled or investigational use of certain drugs. Please review the complete prescribing information for specific drugs or drug combinations—including indications, contraindications, warnings, and adverse effects—before administering pharmacologic therapy to patients.
