Thoracoscopic repair of Morgagni–Larrey hernia in a child – A case report with surgical video

Morgagni-Larrey hernias are a rare form of diaphragmatic hernia, differentiated from the more common Morgagni hernia by their location in the left retro-costo-xiphoid area. In contrast, Morgagni hernias are typically found in the right retro-costo-xiphoid region. These hernias usually contain small amounts of abdominal contents, are covered by a hernial sac, present later in life and are most often repaired via a laparoscopic approach. This case report describes an unusual presentation in a 4-year-old child with significant herniated contents - including small intestine, part of the large intestine and omentum - without a hernial sac, a finding rarely seen even in adults. We managed the child using a thoracoscopic approach, anticipating adhesions between the bowel and thoracic structures, which could be addressed under direct vision. The child recovered uneventfully.