11-month-old Baby Girl Diagnosed with Rare Giant Morgagni Hernia with Intrathoracic Appendicular Gangrene with Perforation Treated Successfully at Dr Mehta’s Hospitals

~ Giant Morgagni hernia was measuring 10cm with appendix perforated intrathoracically and She is the youngest patient to undergo such a complex surgery ~

Chennai, June 2024: In a remarkable medical feat at Dr Mehta’s Hospitals Chennai, an 11-month-old female infant presented with alarming symptoms of abdominal pain, abdominal distension, and non-bilious vomiting 2 episodes for one day, prompting urgent medical attention.

The initial assessment was done by pediatrician Dr Rakesh before the parents took their child to Dr. Mehta’s Hospitals. Followed by the senior consultant of Pediatrics, Dr L K Premkumar assessed the patient. In continuity with this, Dr Raghul diagnosed this as a rare diagnosis of a Giant Morgagni hernia. A thorough examination and diagnostic imaging revealed a giant Morgagni hernia measuring with large bowel loops protruding into the right hemithorax, accompanied by small bowel obstruction.

The child was swiftly shifted to the operation theatre by the team. Dr Raghul, Senior Consultant – Pediatric & Thoracoscopic Surgeon, and Dr Karthikeyan, Pediatric Anesthetist, lead the surgery.

During the intricate surgical intervention, an unexpected revelation emerged as pus was discovered within the right hemithorax, leading to the identification of appendicular gangrene with intrathoracic perforation. Despite the complexities of the case, swiftly and decisively excised the hernia sac and performed an appendectomy. Given the extent of the hernial defect and the appendicular perforation, primary repair was deemed the optimal choice over mesh repair. Following the successful procedure, the infant exhibited a remarkable recovery trajectory and was discharged on the fifth-day post-operation. A follow-up X-ray conducted one month later showcased a normal contour of the diaphragm, affirming the efficacy of the surgical intervention.

This case stands as a significant milestone, representing the youngest patient reported to undergo such a complex surgery, where a combination of giant Morgagni hernia with intra thoracic appendicular perforation in an infant presents a novel scenario. The timely diagnosis and adept management by the medical team at Dr Mehta’s Hospitals underscore the critical, lifesaving nature of their intervention.

Morgagni hernia, a condition where an opening in the diaphragm allows organs, such as the intestines, to protrude into the chest cavity, leading to potential discomfort and requiring medical attention. • Morgagni hernia, though rare, poses significant risks, particularly in infants and children. With over 90% of defects featuring a hernia sac, timely surgical repair is imperative to mitigate complications such as incarceration said Dr Raghul

Dr Mehta’s Hospitals’ expertise in advanced minimally invasive pediatric surgical procedures once again shines through, emphasizing their commitment to surgical excellence and life-saving interventions in challenging cases like this one, Said Dr Saravana Kumar, Group Unit Head of Dr. Mehta’s Hospitals.

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