Giant Morgagni hernia with strangulation, cardiac tamponade, liver rupture and abdominal compartment syndrome in a neonate: a systematic review of associated complications
DOI:
https://doi.org/10.70577/86bh7v35Keywords:
Morgagni hernia, congenital diaphragmatic hernia, cardiac tamponade, abdominal compartment syndrome, neonate, hernia strangulation, postoperative complicationsAbstract
Introduction: Morgagni hernia is a rare form of congenital diaphragmatic hernia, accounting for only 2-5% of all diaphragmatic defects (Köse & Yalçınkaya, 2024; Lauriti et al., 2018). Neonatal presentation is exceptional and usually asymptomatic, but in exceptional cases it may present with serious life-threatening complications (Breinig et al., 2010; Nenekidis et al., 2011). Objective: To synthesize the available evidence on the clinical presentation, diagnosis and management of giant Morgagni hernia in the neonatal period, with emphasis on serious complications such as cardiac tamponade, liver rupture and abdominal compartment syndrome. Methodology: Systematic review following PRISMA 2020 guidelines (Page et al., 2021). A systematic search was conducted in PubMed, LILACS, SciELO and Cochrane for studies published between 2000 and 2025 reporting Morgagni hernias in neonates with associated complications. Case reports, case series and observational studies were included. Methodological quality was assessed using the adapted Newcastle-Ottawa scale (Wells et al., 2000). Results: Eight studies (n=12 patients) were included. Morgagni hernia occurred predominantly on the right side (90%, n=11), with 85.7% (n=12) of cases diagnosed in the early neonatal period (<7 days of life). Cardiac tamponade was reported in 40% (n=5) of cases (Breinig et al., 2010; Nenekidis et al., 2011; Matsushita et al., 2007), while liver rupture was a postoperative complication in 15% (n=2) (Schiergens et al., 2015). Abdominal compartment syndrome was documented in 10% (n=1) (Brophy et al., 2024). Overall mortality was 35% (n=4) (Al-Salem, 2007). Conclusion: Giant Morgagni hernia in the neonatal period can present serious multisystemic complications requiring a high index of suspicion and urgent multidisciplinary management. Early identification through imaging studies and timely surgical correction are essential to reduce associated morbidity and mortality.
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