WOFAPS 2025 8th World Congress of Pediatric Surgery

Özge Kılıç Bayar, İlayda Başar Aksu, Ayten Ceren Bakır, Kıvılcım Karadeniz Cerit, Gürsu Kıyan

Marmara University Faculty of Medicine, Department of Pediatric Surgery, Istanbul

Aim: Morgagni hernia is a rare form of pediatric diaphragmatic hernia, and surgical repair remains the standard treatment. This study aims to share our institutional experience in the management of Morgagni hernias.

Methods: A retrospective review was conducted of patients who underwent surgical repair for Morgagni hernia between 2011 and 2025. Data collected included demographics, associated anomalies, presenting symptoms, diagnostic imaging modalities, surgical techniques, and follow-up outcomes.

Results: Twenty-six patients (14 females, 12 males) with a median age of 62 months (range: 3–187 months) were included. Associated genetic anomalies included trisomy 21 in 7 patients, trisomy 18 in one patient, chromosome 18q deletion in one patient, and type 3 mucopolisaccaridosis in one patient. Seven patients had various congenital cardiac defects but none of them had previous sternotomy. Morgagni hernia was diagnosed incidentally in 16 patients, while others presented with respiratory symptoms including cough (6 patients), dyspnea (2 patients), and recurrent lower respiratory tract infections (2 patients). Abdominal X-ray was suggestive in 8 cases; diagnosis was confirmed by computed tomography in 16 patients and by magnetic resonance imaging in 2 patients. All patients underwent laparoscopic-assisted repair with defect closure via primary suturing reinforced Teflon pledgets and Ethibond® 2-0 sutures. Dual-layer patch repair was required in 2 cases, and hernia sac excision was performed in one patient. Only one recurrence was observed in patients during a median follow-up period of 93 months (range: 3–171 months). Suture-related tissue reaction occurred in 15% of patients: one of them was treated with silver nitrate, in two patients the suture material was excised after 6 months, and removal is planned for one patient.

Conclusion: Laparoscopic-assisted primary repair of Morgagni hernia is a safe and effective technique with a low recurrence rate. Retention of the hernia sac does not appear to affect recurrence.