Brazilian Journal of Case Reports 2023, 3, 3, 8-12. https://doi.org/10.52600/2763-583X.bjcr.2023.3.2.8-12 www.bjcasereports.com.br Case Report Symptomatic congenital Morgagni hernia presenting as a dysp- nea in elderly patient Josue Rueda Cervantes 1 , Jose Angel Facio Treviño 1 , Alberto de Anda Coronado 1 , Luis Fernando Zorrilla Nuñez 1 , Gerardo Ivan Muñoz Morales 1 , Abraham Alexander Alarcon Sandoval 1 , Luis Rodrigo Gomez Alvarez 1 , Gerardo Enrique Muñoz Maldonado 1, * 1 General Surgery Department, Hospital Universitario Dr. Jose Eleuterio Gonzalez, Monterrey, México. * Correspondence: cevam99@gmail.com. Abstract: Morgagni’s hernia is a very uncommon congenital diaphragmatic hernia. A few patients may remain asymptomatic until adulthood. Clinical presentation may include bowel obstruction, chest pain or dyspnea. Here we present a case of symptomatic Morgagni hernia diagnosed in a 64 years' female. A 64-year-old female patient, go to the consultation with a private doctor due to 10 years of evolution of respiratory symptoms due to respiratory symptoms, whose thoracic computed tomography revealed a large Morgagni’s hernia, containing colon. She underwent an elective lapa- roscopic repair with mesh. Morgagni hernias are mostly diagnosed incidentally on a chest radio- graph or can present with cardiorespiratory or abdominal symptoms. Our case was an adult who was diagnosed to have Morgagni hernia presenting with chest symptoms. The investigation of choice to diagnose and evaluate this condition is CT of chest and repair of hernia. Thoracic com- puted tomography is the best imaging study for its diagnosis. Laparoscopic repair is safe and allows symptomatic relief and incarceration risk reduction. Keywords: Hernias; Diaphragmatic; Congenital; Laparoscopy; Dyspnea. 1. Introduction Tumor necrosis factor alpha (anti TNF) inhibitor agents have become an effective therapy and an important advance in the management of chronic inflammatory diseases. The experience accumulated so far demonstrates a good safety profile, low toxicity, and high efficacy [1]. Although safe, this biological therapy option can cause some side effects, especially paradoxical reactions. There is evidence of an increased risk of upper airway infections, reactivation of latent infections, and infusion reactions. It is known that there is a lack of information on specific recommendations for the management of these lesions resulting from the side effect of the use of anti TNF such as infliximabe, etanercept and adalimumab, mainly since the pathophysiology of these reactions is not yet fully under- stood [1]. In 1761, Morgagni described the classical anterior diaphragmatic hernia. It accounts for only 5–10% of congenital diaphragmatic hernias (CDH) [1]. The estimated prevalence of CDH is 1/2000 to 1/5000 live births [2]. In total, 61% of cases occur in females [3]. The ‘foramen’ of Morgagni’s hernia occurs in the anterior midline of the diaphragm, predom- inantly on the right side. A few patients may remain asymptomatic until adulthood [4]. Clinical presentation may include obstructive symptoms from protrusion of the colon, epigastric or chest pain and dyspnea, to name just a few. The finding of mediastinal abnormalities on a chest X-ray, such as widening or air-f luid levels, should raise suspicion of a diaphragmatic hernia. Thoracic computed Citation: Cervantes JR, Treviño JAF, Coronado AA, Nuñez LFZ, Morales, GIM, Sandoval AAA, Alvarez LRG, Maldonado GEM. Symptomatic con- genital Morgagni hernia presenting as a dyspnea in elderly patient. Bra- zilian Journal of Case Reports. 2023 Jul-Sep;03(2):8-12. Received: 27 October 2021 Accepted: 11 January 2022 Published: 21 February 2023 Copyright: This work is licensed un- der a Creative Commons Attribution 4.0 International License (CC BY 4.0).