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  • Title: Right-sided diaphragmatic rupture after repair of a large Morgagni hernia.
    Author: Schiergens TS, Koch JG, Khalil PN, Graser A, Zügel NP, Jauch KW, Kleespies A.
    Journal: Hernia; 2015 Aug; 19(4):671-5. PubMed ID: 26405726.
    Abstract:
    We present a case of a combination of primary and secondary diaphragmatic hernia in a 63-year male patient. For progressive dyspnea and palpitations caused by a large and symptomatic Morgagni hernia resulting in a right-sided enterothorax, an open tension-free mesh repair was performed. The postoperative course was complicated by a secondary hepatothorax through a spontaneous rupture of the right diaphragm. Primary mesh repair of the Morgagni hernia, however, proved to be sufficient. This recurrent herniation might be a consequence of (1) preexisting atrophy of the right diaphragm caused by disposition and/or long-term diaphragmatic dysfunction due to the large hernia, combined with (2) further thinning out of the diaphragm by intraoperative hernia sac resection, and (3) postoperative increase of intra-abdominal pressure.
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