Synchronous Morgagni and Bochdalek Hernias: A Case Report of a Unique Approach to a Rare Finding

Abstract

Introduction: Multipleunilateralcongenitaldiaphragmatichernias(CDH)areextremelyrare,describedonlyfivetimesinthemed-icalliterature. ConcurrentipsilateralBochdalekandMorgagniherniasarerarerstillwithonlytwocasespreviouslydescribed. Inall reportedcasesof multipleconcurrentdefects,theherniaswererepairedinanopenfashion,eitherviaathoracotomyorlaparotomy with both of the two combined Bochdalek and Morgagni hernias repaired via laparotomy. Case Presentation: In this case report we have a 2-day-old who developed respiratory distress and on CT scan was found to have a congenital diaphragmatic hernia (CDH) or eventration. This patient is ideal for this case report because he meets a lot of the previ-ouslyestablishedcriteriaforminimallyinvasiverepairof congenitaldiaphragmatichernias-minimalrespiratorycompromise,no congenitalheartdefects-andhehassynchronousdefectswhichhaveveryrarelybeenseenbefore. Herewepresentthefirstreported caseof concurrentipsilateralBochdalekandMorgagniherniasrepairedinaone-stageminimallyinvasivefashion,approachingthe Bochdalek hernia thoracoscopically and the Morgagni laparoscopically. The patient had a quick recovery post-operatively and he continues to do well. Conclusions: From this experience, we argue that in the right circumstances a completely minimally invasive approach can be taken for synchronous congenital diaphragmatic hernias.