Published online Jan 26, 2024. doi: 10.12998/wjcc.v12.i3.495
Peer-review started: November 13, 2023
First decision: November 22, 2023
Revised: December 4, 2023
Accepted: January 2, 2024
Article in press: January 2, 2024
Published online: January 26, 2024
Processing time: 66 Days and 0 Hours
A Morgagni hernia is an unusual congenital herniation. It is easily misdiagnosed or missed because their symptoms are mild and atypical. In the present report, retrosternal hernias accidentally discovered by ultrasound (US) are described, and their ultrasonic manifestations are analyzed. The US and clinical characteristics are summarized to provide a simple and effective basis for early diagnosis.
Through this report, we can understand more about the clinical and ultrasonic characteristics of rare retrosternal hernia diseases. To add much new insightful information to the field.
To summarize the US imaging characteristics of Morgagni hernias through a comparison of imaging and surgical results.
The records of nine patients with Morgagni hernias diagnosed by US imaging and confirmed by surgery at two children’s hospitals between 2013 and 2023 were collected. The clinical symptoms of the case were summarized. The location, contents and size of the hernia sac were recorded by ultrasound. The clinical and ultrasonic characteristics of the hernia were summarized by comparing with gastrointestinal imaging/computed tomography and surgery.
Between 2013 and 2023, we observed nine (five male and four female) children with Morgagni hernias. All nine Morgagni hernias were first identified by US: (1) Upper abdominal scanning revealed a widening of the prehepatic space, with an abnormal channel extending from under the xiphoid process to the right or left side of the thoracic cavity. Two hernias were on the left side, and seven were on the right side. The abdominal intestinal tube and intestinal air echo crossed this area to the chest in all nine cases; and (2) Chest scanning showed echoes of the bowel and stomach. Intestinal peristalsis and intestinal content movement were observed during the scans.
US imaging can accurately determine the location, extent, and content of Morgagni hernias. Direct signs, such as abnormal channels between the sternum and liver and intestinal tubes and gas entering the chest cavity through these channels, are key. Peristalsis occurs in the anterior chest cavity, and widening of the anterior hepatic space is suggestive of a Morgagni hernia.
The research perspective of this study is to analysed the clinical findings, US features, and operative details of children with Morgagni hernias. In the future studies, we will continue to increase the sample size for more in-depth research, and will analyze the postoperative recurrence rate of retrosternal hernia.