Diaphragmatic hernia. Report of two cases, classification, and review of literature

Abstract

Morgagni-Larrey hernia is uncommon congenital disease in the adults and presents with mild to severe clinical symptoms. In literature, about 80% of Morgagni -Larrey hernia are found on the right side of the chest cavity and have usually a peritoneal sack. Only 2-3% of patients at birth are symptomatic and therefore eligible for urgent surgery. Less severe forms of the disease are characterized by persistent epigastric and subcostal pains sometimes associated with vomiting and are frequently mistaken for dyspeptic disturbances.

We present two case reports; the first one is a patient of 74 years who presented with persistent epigastric pain, vomiting, slight to moderate dyspnea on exertion associated with tachycardia, tachypnea and dyspeptic symptoms. Such symptoms have been going on for the last 6 months. The second patient is a 90 year old woman who was admitted in our ward for abdominal pain and distension associated with vomiting. In both cases a Morgagni-Larrey diaphragmatic hernia was discovered by using esophagogastroduodenoscopy, gastrographyn swallow and CT scan in the first case and only CT scan in the second one.