ASEMPTOMATİK YETİŞKİNDE TESADÜFEN SAPTANAN MORGAGNİ HERNİSİ VE EKSTRALOBER PULMONER SEKESTRASYON BİRLİKTELİĞİ

Öz

Morgagni hernisi (MH), Larr ey aralığı olarak bilinen sternokostal üçgen ya da ön retrosternal diaframdan gelişen nadir konjenital diafragmatik bir defekttir. MH tüm diafragmatik hernilerin %5'inden azını oluşturur. MH genellikle asemptomatiktir, nadiren barsak obstruksiyonu veya strangulasyonu ile hayati tehdit oluşturabilir. MH beraberinde malformasyonlar görülebilir. Pulmoner sekestrasyon (PS) anormal sistemik arteriel kanlanma gösteren kistik ve nonfonksiyone embriyonik akciğer dokusu ile karakterize konjenital malformasyondur. PS sıklıkla sol akciğer alt lobda (%60-90) lokalize olmak üzere intralober sekestrasyon (İS); (%75) ve ekstralober sekestrasyon (ES); (%25) olarak iki gurupta incelenir. Asemptomatik yetişkin erkekte tesadüfen saptanan nadir bir MH ve ES olgusunu paylaşmak istedik. Olguya posterolateral torakotomi uygulanarak, sekestrasyon eksizyonu ve primer herni onarımı yapıldı. Transtorasik yaklaşımın; iyi bir görüş alanı sağlaması, herni kesesinin çevre dokularla oluşturduğu yapışıklıkların kolay serbestleştirilmesi nedeniyle ES gibi intratorasik malformasyonların beraberliği düşünülen olgularda uygun yaklaşım olduğunu düşünmekteyiz.

Anahtar Kelimeler

• Morgagni hernisi, Ekstrapulmoner sekestrasyon, Transtorasik yaklaşım

MORGAGNI HERNIA WITH EXTRALOBAR PULMONARY SEQUESTRATION PRESENTED IN ASYMPTOMATIC ADULT WHICH WERE DIAGNOSED TO COINCIDENTALLY

Öz

Morgagni hernia (MH) is a rare diaphragmatic congenital defect originated in the the sternocostal triangle or the anterior part of the retrosternal diaphragm referred to as Larrey’s space. It is the rarest of all diaphragmatic hernias (<5%). Although is usually asymptomatic it can be lifethreatening because of bowel obstruction or strangulation. MH might also present with associated malformations. We performed procedures of excision of sequestration and primer hernia repair under the posterolatheral thoracotomy. Pulmonary sequestration (PS) is a congenital malformation characterised by cystic, non-functioning embryonic lung tissue with vascularisation of an abnormal systemic artery. They are classified as intralobar (75%) and extralobar (25%) and are more common in the left lung and lower lobes (60-90%). We report a rare case of Morgagni hernia with extralobar pulmonary sequestration (ES) presented in asymphtomatic adult man which were diagnosed to coincidentally. We think that; for the surgical treatment of foramen of MH, the transthoracic approach is the most convenient way to provide good exposure, enabling easy release of the adhesions between the sac and the adjacent tissues and also associated malformations like as ES.

Anahtar Kelimeler

• Morgagni hernia, Extrapulmonary sequestration, Transthoracic approach

Kaynakça

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