ASEMPTOMATİK YETİŞKİNDE TESADÜFEN SAPTANAN MORGAGNİ HERNİSİ VE EKSTRALOBER PULMONER SEKESTRASYON BİRLİKTELİĞİ

Yıl 2011, Cilt: 25 Sayı: 3, 197 - 201, 01.12.2011

Ekrem Şentürk Serdar Şen Selda Şen İbrahim Meteoğlu

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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