Laparoscopic management of a rare combined pathology — Morgagni hernia and hiatal hernia. A case report

Morgagni hernia is a rare form of diaphragmatic hernia characterized by herniation of abdominal viscera through a congenital or acquired defect in the sternocostal triangles of the diaphragm. Its isolated incidence in the general population is estimated at approximately 0.3—0.5 per 1.000 live births. Objective. To present the outcomes of simultaneous surgical treatment in a patient with coexisting Morgagni hernia and hiatal hernia. Case report. A 56-year-old woman with a body mass index of 29 kg/m² and an American Society of Anesthesiologists (ASA) physical status II was admitted to City Clinical Hospital No. 24 with exertional dyspnea and persistent heartburn. The patient reported a three-year history of progressive dyspnea and a 30-year smoking history of approximately 10 cigarettes per day. Instrumental diagnostic evaluation confirmed the presence of both a Morgagni hernia and a hiatal hernia. After standard preoperative assessment and preparation, the patient underwent laparoscopic Nissen fundoplication combined with cruroplasty and repair of the anterior diaphragmatic defect. The procedure lasted 3 hours, with an estimated blood loss of 50 mL. No intraoperative complications occurred. The postoperative course was uneventful, and the patient was discharged on postoperative day 6. Conclusion. This case highlights the rare coexistence of Morgagni hernia and hiatal hernia and supports the safety and efficacy of a laparoscopic approach for their simultaneous surgical repair.