Morgagni-Larrey diaphragmatic hernia as cause of intestinal obstruction in a patient with Marfan's syndrome.

We present the case of a 53-year-old woman with Marfan’s syndrome, who suffered abdominal pain, nausea and vomiting. Laboratory test showed only elevation of leucocytosis (13,450 cells). Chest radiograph revealed the existence of a large air bubble at midthoracic level. Computed tomography (Figs. 1 and 2) revealed the existence of a left diaphragmatic defect at the anterior midline, with partial gastric herniation through it and conditioning a high-grade gastric obstruction. Almost the entire colon and multiple ileal segments were also at intrathoracic position. Following the introduction of a nasogastric tube suction the patient improved significantly, so a scheduled laparoscopic surgery was performed: reduction of viscera into the abdominal cavity and repairing of the left anterior hernial orifice with the placement of prostheses.