Oral Presentation - 55
Clinical features in children with Morgagni hernia and results of surgical treatment
Bilge Gördü, Tutku Soyer, Saniye Ekinci, İbrahim Karnak, Arbay Özden Çiftçi, Feridun Cahit Tanyel
Hacettepe University Faculty of Medicine Department of Pediatric Surgery
Aim: A retrospective study was performed to evaluate the clinical features in children with Morgagni hernia (MH) and results of surgical treatment. Methods: Children operated for MH were evaluated for age, sex, symptoms at admission, diagnostic methods, treatment alternatives and results retrospectively.Results: Thirty-eight cases with MH repair for the last 16 years were included. The mean age of the patients was 4.2 years (1-11 years). Male female ratio was 24:15. The most common symptoms were recurrent respiratory infections (n=15, 39.4%), respiratory problems (n=7, 18.4%) and nausea and vomiting (n= 7, 18.4%). 15.7% of cases were diagnosed during evaluation of other problems with chest X-ray (n=6) and echocardiography in 7.8% (n=3). Eight cases (20.5%) had associated anomaly and 6 of them (15.3%) have been following with Down syndrome. The most common associated anomalies were seen in cardiac (n=4, 10.5%) and skeleton system (n=3, 7.8%). Diagnosis was obtained by chest X-ray in 27 cases and upper gastrointestinal series in 4 cases. Twelve cases had been referred after evaluation with computed tomography with a presumptive diagnosis of cystic lung disease. Sixteen cases underwent echocardiography but only 4 of them had cardiac anomaly. Hernia repair was performed with midline incision starting form xiphoid 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 time was postoperative 2.5 day (2-5 days). After a mean 5.7 years (1-16 years) follow-up, 3 of the cases (7.8%) reoperated for recurrence. Two of the recurrent cases had Down syndrome. Conclusion: MH presents with non-specific symptoms and are diagnosed with radiologic investigations during evaluations for other causes in children. One fifth of the cases had associated anomalies and cases with Down syndrome should be closely followed-up because of risk of recurrence.