Morgagni Hernia with Intestinal Obstruction in Adults with Diaphragmatic Plasty: Case Report

Morgagni hernia is a rare form of congenital diaphragmatic hernia that represents 2% to 5% of all diaphragmatic hernias, with an estimated incidence of 1 in 2000 to 1 in 5000 live births (1,2). It was described by Giovanni Battista Morgagni in 1769 (3). It results from the failure of fusion of the anterior pleuroperitoneal membrane with the sternum and costal cartilages (4). The contents of the hernia sac may include omentum, colon, stomach, and even liver (5). The diagnosis is primarily made through computed tomography (6). A 64-year-old female patient with a history of arterial hypertension and diabetes mellitus presented with a clinical course of six days characterized by abdominal distension, right hypochondrium pain, nausea, vomiting, and decreased bowel transit. Physical examination revealed abdominal distension with tympanism and tenderness on deep palpation in the right hypochondrium. CT confirmed an anterior right diaphragmatic defect measuring 32 mm, with herniation of abdominal fat and the hepatic angle of the colon, which was compressed causing intestinal obstruction. Exploratory laparotomy was performed, identifying a Morgagni hernia with a 4 × 3 cm defect and a hernia sac measuring 10 × 5 cm containing transverse colon and necrotic omentum. Necrotic omentum resection, reduction of the herniated contents, sac ligation, and primary closure of the diaphragmatic defect were performed. A comprehensive review of 17 indexed articles published between 2020 and 2025 was conducted, consolidating information on epidemiology, clinical presentation, diagnostic methods, and surgical management of this pathology. It is concluded that surgical repair should be indicated in all cases, preferring the laparoscopic approach when possible, using mesh in defects greater than 4 cm, and individualizing sac resection (8–17). This article provides an updated, evidence-based perspective on the management of Morgagni hernia in adults