Abstract
<title>Abstract</title> <p>Introduction: Morgagni-Larrey hernia, a left-sided anterior congenital diaphragmatic defect, accounts for only 2–8% of all Morgagni hernias and frequently remains clinically silent into adulthood. Diaphragmatic injuries are misdiagnosed in up to 33% of cases, with untreated cases carrying mortality rates between 25% and 80%. Trauma-induced unmasking of such latent defects poses significant diagnostic and surgical challenges. Case Report: A 35-year-old female presented with shortness of breath and left-sided chest pain three days following a fall from 10 feet. She was haemodynamically unstable on arrival. Chest X-ray and contrast-enhanced computed tomography confirmed herniation of the greater omentum, transverse colon, and gastric fundus through a left-sided diaphragmatic defect measuring 10×7 cm (American Association for the Surgery of Trauma Grade IV), with collapse of the left lower lobe of the lung — representing a latent Larrey hernia unmasked by blunt trauma. Following resuscitation and multidisciplinary consultation, laparoscopic repair was performed using primary suture closure with non-absorbable suture, reinforced with a composite polypropylene-oxidised cellulose mesh. Tack fixation was avoided near the pericardium ; vicryl sutures were used instead to prevent iatrogenic cardiac tamponade. An intraoperative intercostal drain ensured complete lung re-expansion. The patient was discharged uneventfully on postoperative day 4. Conclusion Latent congenital diaphragmatic hernias can be unmasked by blunt trauma and must be considered in any patient with cardiorespiratory compromise following thoracoabdominal injury. Laparoscopic repair with mesh reinforcement is safe and effective for large defects, provided careful attention is given to anatomical danger zones like mediastinum during fixation.</p>