ABSTRACT
INTRODUCTION: Morgagni hernia is rare clinical entity accounting for 3% of all surgically treated diaphragmatic hernias. Similarly, paraesophageal hernia constitutes only 5% of all hiatal hernia. The co-existing of these two hernias is extremely rare with only 10 cases reported in the literature. PRESENTATION OF CASE: We present a case of 53-year-old female patient with 6-year history of reflux disease. Her symptoms were poorly controlled by medications and she was seeking a surgical treatment. Preoperative assessment revealed a giant paraesophageal hernia for which a laparoscopic repair was planned. During the surgery, left-sided Morgagni hernia was discovered and both hernias were repaired at the same time. The patient tolerated the procedure well without complications. CONCLUSION: The co-existence of Morgagni and Hiatal hernia is rare and the simultaneously laparoscopic repair of both hernias is safe and feasible.
ABSTRACT
INTRODUCTION: Different therapeutic measures have been developed in the treatment of obesity. Gastric balloon is a minimally-invasive modality in obesity treatment, but it is not without a risk of complications. PRESENTATION OF CASE: We present a 44-year-old morbidly obese lady who underwent gastric balloon insertion and refused to remove it at the recommended time. Unfortunately, after 18 months from insertion of the balloon, she was brought to the Emergency Department with symptoms of gastric outlet obstructions. Endoscopic retrieval of the balloon has failed. Hence, surgical intervention was planned and the balloon was successfully removed laparoscopically. DISCUSSION: Gastric balloons are designed to remain in the stomach for 6 months. Delayed extraction of the balloon associated with increase in the rate of complications. In our case, it was difficult to retrieve the balloon endoscopically due to thickened balloon wall, which was then removed laparoscopically safely without any complications. CONCLUSION: Laparoscopic extraction of the gastric balloon is a safe and feasible option in the management of difficult endoscopic retrieval.
