Simultaneous Morgagni and Bochdalek Hernias in an Adult: A Rare Case Diagnosed Radiologically and Treated by Laparoscopic Repair

Abstract

Introduction: Diaphragmatic hernias are typically congenital and diagnosed in neonates or infants. Their discovery in adulthood is rare and often incidental (Shankar et al., 2023). The simultaneous presence of a Morgagni hernia and a Bochdalek hernia in an adult is exceptionally uncommon. Case Presentation: We report the case of a 47-year-old male, with no significant medical history, who presented with prolonged fever, asthenia, anorexia, and weight loss. Thoracoabdominal computed tomography demonstrated a right anterior diaphragmatic defect containing omental fat and bowel loops, consistent with a Morgagni hernia. Intraoperative laparoscopic exploration subsequently revealed a second anatomically distinct posterolateral diaphragmatic defect compatible with a Bochdalek hernia. Both were treated successfully by laparoscopic repair. Postoperative recovery was uneventful. Discussion: Dual diaphragmatic hernias in adults may remain asymptomatic or present with nonspecific gastrointestinal or respiratory symptoms. Computed tomography is the gold standard for diagnosis, enabling precise localization and characterization of the herniated contents (Giuffrida et al., 2023, Schembari et al., 2024, Chandrasekharan et al., 2017). Laparoscopy provides both diagnostic and therapeutic benefits, offering direct visualization of the diaphragm and minimally invasive repair with excellent outcomes (Sioda et al., 2022). Conclusion: This case underscores the importance of detailed imaging in atypical clinical presentations and highlights the safety and efficacy of laparoscopic management for dual congenital diaphragmatic hernias in adults.