Abstract

Aim: retrospective study was planned to evaluate the clinical features in children with Morgagni hernia (MH) and results of surgical treatment.

Material and Methods: Children operated for MH were evaluated retrospectively regarding age, sex, symptoms at admission, diagnostic methods, treatment alternatives and outcomes.

Results: Thirty-eight cases that underwent MH repair within the last 16 years were included in the study. Mean age of the patients was 4.2 years (1-11 years). Male/ female ratio was 23:15. The most common admission complaints were recurrent respiratory infections (n=15, 39.4%), respiratory problems (n=7, 18.4%) and nausea and vomiting (n=7, 18.4%). In 15.7% of the cases hernia was diagnosed during evaluation of other problems using chest X-ray (n=6) and echocardiography in 7.8% (n=3) of the cases. Eight cases (20.5%) had associated anomalies and 6 of them (15.3%) were being followed up with Down syndrome. The most common associated anomalies were cardiac (n=4, 10.5%) and skeletal system anomalies (n=3, 7.8%). Diagnosis was made by chest X-ray in 27 cases and contrast-enhanced upper gastrointestinal series in 4 cases. Twelve cases had been referred to us after evaluation with computed tomography with a presumptive diagnosis of cystic lung disease. Sixteen cases underwent echocardiographic examinations but only 4 of them had cardiac anomaly. Hernia repair was performed through midline incision exteding from subxiphoid region to umbilicus. Hernia sac was totally excised in 2 cases whereas the rest of them were imbricated. Mean hospitalization time was 6.79 days (4-22 days) and oral feeding was started on postoperative 2.5 day (2-5 days). After a mean 5.7 years of (1-16 years) follow-up, 3 cases (7.8%) were reoperated for recurrence. Two of the recurrent cases had Down syndrome.

Conclusion: MH presents with nonspecific symptoms and it is diagnosed with radiologic investigations during evaluations for other causes in children. One fifth of the cases had associated anomalies and cases with associated Down syndrome should be closely followed-up because of risk of recurrence after hernia repair.