Journal of Clinical and Diagnostic Research, ISSN - 0973 - 709X

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Salient features of the JCDR: It is a biomedical, multidisciplinary (including all medical and dental specialities), e-journal, with wide scope and extensive author support. At the same time, a free text of manuscript is available in HTML and PDF format. There is fast growing authorship and readership with JCDR as this can be judged by the number of articles published in it i e; in Feb 2007 of its first issue, it contained 5 articles only, and now in its recent volume published in April 2011, it contained 67 manuscripts. This e-journal is fulfilling the commitments and objectives sincerely, (as stated by Editor-in-chief in his preface to first edition) i e; to encourage physicians through the internet, especially from the developing countries who witness a spectrum of disease and acquire a wealth of knowledge to publish their experiences to benefit the medical community in patients care. I also feel that many of us have work of substance, newer ideas, adequate clinical materials but poor in medical writing and hesitation to submit the work and need help. JCDR provides authors help in this regards.
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Thanking you
With sincere regards
Dr. Rajendra Kumar Ghritlaharey, M.S., M. Ch., FAIS
Associate Professor,
Department of Paediatric Surgery, Gandhi Medical College & Associated
Kamla Nehru & Hamidia Hospitals Bhopal, Madhya Pradesh 462 001 (India)
On May 11,2011

Dr. Shankar P.R.

"On looking back through my Gmail archives after being requested by the journal to write a short editorial about my experiences of publishing with the Journal of Clinical and Diagnostic Research (JCDR), I came across an e-mail from Dr. Hemant Jain, Editor, in March 2007, which introduced the new electronic journal. The main features of the journal which were outlined in the e-mail were extensive author support, cash rewards, the peer review process, and other salient features of the journal.
Over a span of over four years, we (I and my colleagues) have published around 25 articles in the journal. In this editorial, I plan to briefly discuss my experiences of publishing with JCDR and the strengths of the journal and to finally address the areas for improvement.
My experiences of publishing with JCDR: Overall, my experiences of publishing withJCDR have been positive. The best point about the journal is that it responds to queries from the author. This may seem to be simple and not too much to ask for, but unfortunately, many journals in the subcontinent and from many developing countries do not respond or they respond with a long delay to the queries from the authors 1. The reasons could be many, including lack of optimal secretarial and other support. Another problem with many journals is the slowness of the review process. Editorial processing and peer review can take anywhere between a year to two years with some journals. Also, some journals do not keep the contributors informed about the progress of the review process. Due to the long review process, the articles can lose their relevance and topicality. A major benefit with JCDR is the timeliness and promptness of its response. In Dr Jain's e-mail which was sent to me in 2007, before the introduction of the Pre-publishing system, he had stated that he had received my submission and that he would get back to me within seven days and he did!
Most of the manuscripts are published within 3 to 4 months of their submission if they are found to be suitable after the review process. JCDR is published bimonthly and the accepted articles were usually published in the next issue. Recently, due to the increased volume of the submissions, the review process has become slower and it ?? Section can take from 4 to 6 months for the articles to be reviewed. The journal has an extensive author support system and it has recently introduced a paid expedited review process. The journal also mentions the average time for processing the manuscript under different submission systems - regular submission and expedited review.
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Overall, the publishing process with JCDR has been smooth, quick and relatively hassle free and I can recommend other authors to consider the journal as an outlet for their work."

Dr. P. Ravi Shankar
KIST Medical College, P.O. Box 14142, Kathmandu, Nepal.
On April 2011

Dear team JCDR, I would like to thank you for the very professional and polite service provided by everyone at JCDR. While i have been in the field of writing and editing for sometime, this has been my first attempt in publishing a scientific paper.Thank you for hand-holding me through the process.

Dr. Anuradha
On Jan 2020

Important Notice

Case report
Year : 2011 | Month : August | Volume : 5 | Issue : 4 | Page : 853 - 855

Diaphragmatic Hernia Presenting as a Gastric Volvulus

Prathvi Shetty, Leo F. Tauro, Rajeevkumar Chaudhary, Uday Kumar

Department of surgery, Father Muller Medical Collage and Hospital. Kankanady, Mangalore - 575002, Karnataka, India.

Correspondence Address :
Dr. Shetty Prathvi, Department of Surgery
FMMCH, Kankanady, Mangalore-575002
Karnataka, India.
Mobile: +91-9886839423


Gastric volvulus is a rare clinical entity defined as an abnormal rotation of the stomach and it presents with the features of gastric outlet obstruction. The precipitating factors are usually idiopathic or due to abnormal laxity of the gastrosplenic, gastroduodenal, gastrophrenic and gastrohepatic ligaments or in cases of paraesophageal hernias. In adults, the most common causes of gastric volvulus are the diaphragmatic defects. We present a case of a 65 yrs old lady, who came with the symptoms of gastric outlet obstruction, which on initial investigation pointed towards the diagnosis of a gastric volvulus. On laprotomy, the stomach was found to be incarcerated in a right-sided Morgagni hernia with surrounding adhesions. The hernia through the foramen of the Morgagni is uncommon in adults, accounting for only 3% of all the treated diaphragmatic hernias. The treatment for these hernias primarily is surgical repair or sometimes, repair by the use of prosthetic material. We report a rare case of a Morgagni hernia presenting as gastric volvulus.


Gastric volvulus, Morgagni hernia, Diaphragmatic hernia

A Morgagni hernia is a congenital herniation of the abdominal contents into the thoracic cavity through a retrosternal diaphragmatic defect. The reported incidence of congenital diaphragmatic hernias is estimated to be 1 in between 2000 to 5000 births. Morgagni hernias comprise 2% of all the diaphragmatic hernias. The foramen of the Morgagni hernia occurs in the anterior midline through the sternocostal hiatus of the diaphragm, with 90% of the cases occurring on the right side. Most of the Morgagni hernias are found and repaired in children, but 5% of them are found in adults (1). They are usually asymptomatic and are often found incidentally on chest radiography. The symptoms of these hernias are attributable to the herniated viscera. In adults, diaphragmatic defects do present as a gastric volvulus (2). We present a case of a 65 yrs old lady with Morgagni hernia, presenting as gastric volvulus.

Case Report

A 65 yrs old lady presented to us with complaints of epigastric pain of 6 months duration, which was associated with retching and vomiting for one month. She used to vomit immediately after the intake of food. There was no history of fever, abdominal distension or bowel disturbances. On abdominal examination, epigastric tenderness was elicited. No palpable mass was found. The Digital rectal examination was normal.

Her routine blood and urine examination results were within normal limits. Her abdominal ultrasound was normal. Upper gastrointestinal endoscopy could not be navigated past or pyloric antrum found and gastric volvulus was queried. A barium meal study showed an mesentrico axial type of gastric volvulus (Table/ Fig 1). On further detailed examination, the radiologist suggested the possibility of a Morgagni hernia with stomach herniation. A nasogastric tube placement was unsuccessful.

The abdomen was opened by making an upper midline incision. A right morgagni hernia with stomach and omental herniation,which was associated with minimal adhesions was present. (Table/ Fig 2).The contents were reduced by using gentle traction and the defect was closed with suture material prolene 2.0 in two layers. The gastro-colic ligament was freed. A right ICD tube was inserted. The post operative period was uneventful. The patient was asymptomatic on 6 months of follow up.


Diaphragmatic hernias can be divided into two broad categories: congenital diaphragmatic defects and acquired diaphragmatic defects. Congenital diaphragmatic hernias (CDH) occur when the muscular entities of the diaphragm fail to develop normally, resulting in the displacement of the abdominal components into the thorax and most patients present with it early in life rather than later. However, a subset of adults may present with a congenital hernia that was undetected during childhood (3).

The three basic types of congenital diaphragmatic hernias are posterolateral Bochdalek hernia anterior Morgagni hernia and the hiatus hernia. Left-sided Bochdalek hernia is seen in approximately 90% of the cases. Morgagni hernia is a less common form of congenital diaphragmatic hernia, occurring in only 5-10% of the cases. This hernia occurs in the anterior midline through the sternocostal hiatus of the diaphragm, with 90% of the cases occurring on the right side. Morgagni hernia is a rare type of congenital diaphragmatic hernia which may not be symptomatic until adulthood, when the patient presents with acute symptoms or incarceration (4).

Congenital hernias (of childhood or adult onset) present with obstructive symptoms like the protrusion of the colon, chest pain, tightness or fullness in the chest and sepsis following strangulation or perforation and many present with respiratory symptoms (5). The diaphragmatic defects do present as gastric volvulus (2). The classic triad which is associated with gastric volvulus of severeepigastric pain, retching without vomiting, and inability to pass a nasogastric tube, was described by Borchardt in 1904.This triad was present in our patient.

Plain pulmonary roentgenogram, radiological studies of the gastrointestinal system with contrast material, computerized tomography and magnetic resonance imaging studies are helpful in its diagnosis (6).

Surgical management is the right option and if it is in the neonatal period, a subcostal incision may be used. An attempt must be made to repair the hernia with a primary repair. However, a prosthetic material such as PTFE must sometimes be used. In the latent period, a thoracotomic or laparotomic approach can be used. Most surgeons make an approach with laparotomy so that the abdominal contents can be inspected adequately (7). Minimally invasive approaches are currently being explored via video-assisted thoracoscopic or laparoscopic means (8). Laparoscopy provides an excellent route for both the diagnosis and the repair of a Morgagni’s hernia. The defect is repaired either by primary suture or by the use of a prosthetic mesh. In adults, a prosthetic non-absorbable mesh (PTFE, Polypropylene) repair is preferred to reconstruct or cover the defect. Extra corporeal or intra corporeal suture placement or staples are used to maintain the mesh in position. However, unless the mesh is covered with a layer of peritoneum, the intraabdominal viscera may adhere to it, thus creating a setting in which small bowel obstruction is more likely at a future time. The use of staples alone to close the diaphragmatic defect has also been described but is only possible when a very small defect is present. Endoscopic surgery entails less postoperative pain and a shorter hospital stay.


This case report highlights the unusual presentation of obstructed viscera (Gastric volvulus) within a Morgagni’s hernia in an elderly patient.


Barut I, Tarhan OR, Cerci C, Akdeniz Y, Bulbul M. Intestinal obstruction caused by a strangulated Morgagni hernia in an adult patient. J Thoracic Imaging. 2005; 20:220-2.
Iso Y, Sawada T, Rokkaku K, Furihata T, Shimoda M, Kita J, et al. A case of symptomatic Morgagni’s hernia and a review of Morgagni’s hernia in Japan (263 reported cases) Hernia. 2006;10:521–4
Wiseman NE, MacPherson RI. “Acquired” congenital diaphragmatic hernia. J Pediatr Surg. 1977;12:657-65.
Rogers FB, Rebuck J A Case report: Morgagni hernia. Hernia. 2006 ; 10(1):90-2..
Harford WV, McArthur KE. Diverticula, hernias, volvulus, and rupture. In: Sleisenger MH, Fordtran JS. Gastrointestinal Disease: Pathophysiology, Diagnosis, Management. 5. Philadelphia, PA: Sunders; 1993:481-483.
Colakoglu O, Haciyanli M, Soyturk M, Colakoglu G, Simek I. Morgagni hernia in an adult: atypical presentation and diagnostic difficulties Turk J Gastroenterol. 2005;16:114-6.
Yilmaz M, Isik B, Coban S, Sogutlu G, Ara C, Kirimlioglu V, Yilmaz S, Kayaalp C. A transabdominal approach in the surgical management of Morgagni hernia. Surg Today. 2007;37:9-13.
Durak E, Gur S, Cokmez A, Atahan K, Zahtz E, Tarcan E.Laparoscopic repair of Morgagni hernia. Hernia. 2007;11:265-70.

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