Giant Morgagni Hernia with Transthoracic Herniation of the Left Liver Lobe and Transverse Colon: a Case Report

Background: A Morgagni hernia is a rare diaphragmatic hernia that is usually asymptomatic but can present with gastrointestinal and chest symptoms and is reported in many cases with strangulation. Here we report a rare case of a Morgagni hernia with transthoracic herniation of the left lobe of the liver and transverse colon that presented with abdominal pain.

Case Presentation: A 54-year-old Saudi female presented with abdominal pain, vomiting, and shortness of breath. Chest radiography revealed an air-containing viscus and a wide mediastinum. Computed tomography confirmed the presence of a right-sided Morgagni hernia. Reduction of the defect contents and repair of the hernia together with cholecystectomy were successfully performed using the laparoscopic approach. The patient recovered smoothly with complete resolution of preoperative symptoms.

Conclusion: A Morgagni hernia is a rare diaphragmatic defect with an increased risk of incarceration. In addition to the omentum, transverse colon, and small bowel, the defect may involve the left lobe of the liver. Surgical repair is recommended in all cases of Morgagni hernia, to avoid the risk of incarceration.