Down Sendromu Anal Atrezi Pectus Carinatum ve Konjenital Hipotiroidinin Eşlik Ettiği Ventriküler Septal Defekt ve Konjenital Morgagni Hernisinin Sternotomi ile Başarılı Onarımı

Olgu sunumumuzda, 5 aylık Down sendromlu kız hastada yapılan başarılı konjenital Morgagni hernisi ve ventrikül septal defekt onarımını sunmaktayız. Median sternotomi yaklaşımıyla aynı seansta yapılan onarımlarda kardiyopulmoner bypass eşliğinde VSD, polytetrafluoroethylene yama ile kapatıldı. Diaframdaki defekt ise primer olarak, transabdominal yaklaşıma gerek olmadan onarıldı. Postoperatif seyir sorunsuzdu.

Anahtar Kelimeler:

Morgagni Hernisi, Hipotiroidi, Ventriküler Septal Defekt, Anal Atrezi, Pectus Carinatum

Successful Repair of Congenital Morgagni Hernia and Ventricular Septal Defect via Median Sternotomy in a Patient with Down Syndrome, Anal Atresia, Pectus Carinatum and Congenital Hypothyroidism

Here we report a 5-month-old female patient with Down syndrome who was successfully operated on due to congenital Morgagni hernia and ventricular septal defect concomitantly via median sternotomy. Ventricular septal defect was repaired with a polytetrafluoroethylene patch through the right atriotomy using cardiopulmonary bypass, and diaphragmatic hernia was repaired primarily with prolene sutures reinforced with teflon pledgets after excising the diaphragmatic hernia pouch simultaneously. Entire operation was completed via median sternotomy, and transabdominal approach was not required to repair the diaphragmatic hernia. Postoperative course was uneventful.

Keywords:

Congenital Morgagni Hernia Ventricular Septal Defect, Median Sternotomy, Down Syndrome, Anal Atresia, Pectus Carinatum,

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Bassareo PP, Neroni P, Montis S, Tumbarello R. Morgagni’s diaphragmatic hernia mimicking a severe congenital heart disease in a newborn: a case report. J Med Case Rep 2010; 4: 395. google scholar
Yang W, Carmichael SL, Harris JA, Shaw GM. Epidemiologic characteristics of congenital diaphragmatic hernia among 2.5 million California births, 1989-1997. Birth Defects Res A Clin Mol Teratol 2006; 76: 170-4. google scholar
deHoyos A. Foramen of morgagni hernia. In: Shields TW, LoCicero JR, Reed CE, editors. General thoracic surgery. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2009. p. 719-24. google scholar
Al-Salem AH. Congenital hernia of Morgagni in infants and children. J Pediatr Surg 2007; 42: 1539-43. google scholar
Adebo OA, MB, BS, FRCS(C), DABS, DABTS et all. Scimitar Syndrome with associated Morgagni hernia in a Nigerian infant. J Nati Med Assoc 1979; 71: 10. google scholar
Pokorny WJ, McGill CW, Harberg FJ. Morgagni hernias during infancy: Presentation and associated anomalies. J Pediatr Surg 1984; 19: 394-7. google scholar
Deng X, Liu P, Yi L, Wang J, Huang P. A rare case of Morgagni hernia associated with cor triatriatum. J Pediatr Surg Case Rep 2015; 3: 19-21. google scholar
Berman L, Stringer D, Ein SH, Shandling B. The late-presenting pediatric morgagni hernia: A benign condition. J Pediatr Surg 1989; 24: 970-2. google scholar
Rashid F, Chaparala R, Ahmed J, Iftikhar SY. Atypical right diaphragmatic hernia (hernia of Morgagni), spigelian hernia and epigastric hernia in a patient with Williams syndrome: a case report. J Med Case Rep 2009; 3: 7. google scholar
Mert M, Gunay I. Transsternal repair of Morgagni hernia in a patient with coexistent ventricular septal defect and Down syndrome. Acta Chirurgica Belgica 2006; 106: 739-40. google scholar
Oppelt PU, Askevold I, Bender F, Liese. J, Padberg W, Hecker A et al. Morgagni-Larrey diaphragmatic hernia repair in adult patients: a retrospective single-center experience. Hernia 2021 25: 479-89. google scholar
Daifoladi A A, Talemi H G, Rezaei M A, Wardak A F, Negin F, Mousavi S H. Concomitant trans-sternal repair of Morgagni hernia and ventricular septal defect in a patient with Down syndrome: A case report. Int J Surg Case Rep 2022; 92: 106911. google scholar
Shahri H M M, Ghiasi S S, Shaye Z A, Zegheibizadeh F. Congenıtal heart defects in infants with a congenital diaphragmatic hernia: a single-center experience. Pak Heart J. 2022;55(04): 408-12. google scholar