Isao Murayama

Laparoscopic repair of Morgagni hernia with composite mesh in an elderly woman: Report of a case

A 78‐year‐old woman was admitted to another hospital with vomiting. Chest X‐ray showed an abnormal shadow in the lower right lung field, and CT indicated a Morgagni hernia containing the stomach and transverse colon. The patient was transferred to our hospital and underwent laparoscopic surgery. After the hernia contents were repositioned into the abdominal cavity, we repaired the hernia orifice with a prosthetic mesh to achieve a tension‐free repair. There were no complications after the surgery, and there has been no recurrence. The patient has remained free of clinical symptoms since 10 months after the surgery. Laparoscopic repair with a prosthetic mesh for Morgagni hernia is a simple and safety procedure for elderly patients.

Endoscopic Ultrasonography for Esophageal Achalasia

Although esophageal achalasia is a motor disorder, it is a fact that achalasia is associated with obvious structual change such as the absence of ganglion cell, atrophy or hypertrophy of the muscular layers [1]. Even at the operation, in some cases of esophageal achalasia, esophageal wall thickening can be recognized. This esophageal wall thickening was evaluated by endoscopic ultrasonograph (EUS) preoperatively. This study was done to document the result with the relations between the EUS findings and x-ray findings, and manometric measurements of esophageal pressure.