Incidentally Diagnosed Large Asymptomatic Morgagni Hernia in Adult Male Patient.

Background: Congenital diaphragmatic hernias are rare congenital defects resulting in abdominal organ protrusion into the thoracic cavity; they mainly present with pulmonary or gastrointestinal symptoms. Although congenital and discovered in utero or in early childhood, they can be asymptomatic for a long time and even remain asymptomatic despite the growing hernia sac dimensions and the hernia sac contents. Case description: We present a case of a 58-year-old patient with incidentally diagnosed Morgagni hernia during the COVID-19 pandemic following a computerised tomography (CT) scan of the chest. He presented without any symptoms related to the existence of the hernia. Another CT scan was performed 20 months after the initial diagnosis to evaluate the progression of the hernia. The patient refused the offered surgery due to the absence of symptoms. Discussion: A Morgagni hernia is usually discovered during pregnancy or in early childhood, but sometimes can be asymptomatic for years. Main symptoms originate from the respiratory and gastrointestinal system. Conclusion: Due to the refusal of surgery, we were able to follow the CT scan enlargement progression of patients' hernia over a 20-month period. LEARNING POINTS: Congenital diaphragmatic Morgagni hernias can remain undiscovered for a long period of time.Despite the usual clinical presentation with pulmonary and/or gastrointestinal symptoms, it can be asymptomatic in some patients.Surgery is the recommended treatment for a Morgagni hernia (via the thoracic or abdominal access).

Enhancing surgical planning of distal splenopancreatectomy through 3D printed models: a case report.

The complex anatomy of the peripancreatic region was a challenge to many surgeons in the past. Up until recently, the only way to prepare and plan a surgery was through the use of traditional 2D images, obtained via computed tomography or magnetic resonance imaging. Recently, the advantages in the field of 3D printing (also called additive manufacturing, or rapid prototyping) allowed the creation of replicas of the patient's anatomy which is to be used for preoperative planning and visual reference. We present the case of a 46-y.o. patient with a distal pancreatic lesion requiring a distal splenopancreatectomy, who benefited from the use of 3D printing technology. No intraoperative or postoperative complications were encountered, while the created model was used to plan and perform the needed resection.