PMC5121438_01
PMC5121438_02
Thoracic CT scan. Stomach filled by contrast in right hemithorax.
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fig1
Clinical exam and diagnostic imaging including CXR and spiral thoracoabdominal CT scan were compatible with Morgagni hernia (Figure 1).
PMC5121438_03
Chest X-ray. Mass with air-fluid level in right hemithorax.
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fig2
A chest X-ray was done and showed round opacity with air-fluid level at right hemithorax on the dome of the diaphragm (Figure 2).
Intraperitoneal cavity. Pulling out hernia sac content back into abdomen by noncrashing grasper.
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fig3
Intraoperatively, hernial sac content (colon, omentum, and part of stomach) was pulled out and reduced back into the abdominal cavity (Figure 3).
Excision of the sac.
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fig4
The falciform ligament was divided and the hernia sac was excised at first two cases by LigaSure (Figure 4), but at operation of the third patient, the hernial sac had not been removed.
Fixation of mesh to anterior abdominal wall.
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fig5
Mesh was expanded over the defect and fixed to the anterior abdominal wall and edge of the diaphragmatic defect in the posterior part with spiral tacks (Protack , Covidien, Mansfield, MA, USA) (Figure 5).