Anesthetic management for laparoscopic repair of Morgagni-Larry hernia in a child

摘要

A 5-year-old asymptomatic boy was shown to have bowel loops in the thoracic cavity incidentally in a chest radiograph. A barium swallow confirmed the diagnosis of Morgagni hernia. Laparoscopic repair under CO2 pneumoperitoneum was performed. Anesthesia was induced and maintained with air, oxygen and sevoflurane. After pulling the transverse colon and the greater omentum into the abdomen, it was found that a part of the liver was also herniated into the right sternocostal hiatus (Larry hernia). The patient showed uneventful recovery. However, we should realize that dissection of adhesions between the viscera and peritoneal sac may be dangerous with possibility of pneumomediastinum or pneumothorax under pneumoperitoneum.