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Association of Down syndrome and morgagni hernia.

Morgagni hernia is a rare type of congenital diaphragmatic hernia. Although frequently asymptomatic, it may cause different respiratory and gastrointestinal complaints. Associated anomalies frequently like congenital heart disease, Turner syndrome, Prader-Willi syndrome, Noonan syndrome, omphalocele, retroperitoneal teratoma and genitourinary anomalies (1, 3, 4, 5, 6, 7, 11, 10). In literature the association with Down syndrome was reported in 19 cases (6,9).A 7-month old girl was admitted to the hospital with a respiratory distress complaint which had been present since birth. She was the 6th child of consanguineous parents and maternal age was 37 years old. On physical examination; weight was 7 kg (10-25 percentile), height 65 cm (25-50 percentile) and head circumference 42 cm (3-10 percentile). She had the typical clinical findings of Down syndrome. The routine hemogram and biochemical studies were normal except for leukocytosis (21.000 /mm3; normal range 6.000-18.000/ mm3). Serum C-reactive protein was evaluated 24 mg/L (normal range Morgagni foramen is at the anteromedial part of chest wall and transvers septum integration and it is 90 % rightly, 8 % leftly (12). This type of hernia is the least seen congenital diaphragmatic hernias and its frequency varies between 1 % and 5.1 % at large series (2,10,13). Morgagni hernia is rarely seen at neonatal and infancy period with cyanosis and respiratory distress. In some cases cough, vomits after nutrition, constipation, diarrhea, growth retardation, abdominal distension and respiratory tract infections can be seen (1,10). Our case also had respiratory distress and she was being receiving lower respiratory tract infection treatment. Some cases can be diagnosed incidentally with seeing air-fluid levels or solid masses at retrosternal region or right part of chest radiograph (1). We diagnosed morgagni hernia in our case with carefully examination of the chest radiograph. Trauma or increased intra-abdominal pressure may cause herniation and formation of the symptoms. As our patient had hospitalization history when she was 7 days old and no diagnosis of morgagni hernia at this time period may be due to this. When literature was revised over only 19 morgagni hernia cases were seen with Down Syndrome. Presentation age varies from neonatal period to second decade (5, 13). …