Hernia de Morgagni-Larrey incidental en el adulto: diagnóstico y tratamiento

Introduction: Morgagni hernia (right side) or Larrey Hernia (left side) is a rare congenital diaphragmatic hernia cause by a defect in the septum transversum. They are usually asymptomatic, but they can cause respiratory and/or digestive symptoms. A 90% of hernias occur in the right diaphragm (Morgagni Hernia). Its prevalence is higher in women (2:1). The bowel, omentum, ileocecal angel, liver or stomach can herniate into the chest. \n \nClinical case: we present the case of an adult patient with a large asymtomatic Morgagni hernia discovered incidentally in the preoperative study of an ovarian tumor. \n \nDiscussion: a simple chest X-Ray and abdominal CT scan are essential for diagnosis. The treatment of a Morgagni hernia is always surgical even when the patient is asymptomatic and it is intended to prevent complications. The abdominal or thoracic surgical approach allows simple repair of the defect. The approach path depends on the charasteristics of the hernia. The surgical repair consists of the reduction of the hernia content and the closure of the diaphragmatic orifice. If the hernia defect is large, prosthetic meshes may be used. \n \nConclusion: we present a case of asymptomatic Morgagni hernia, discovered incidentally and which the patient refused to undergo surgical intervention. The etiology, the diagnosis and the treatment of this infrequent pathology are discussed.