From the Research
The hydatid of Morgagni is a benign, pedunculated, cystic structure that is usually of no clinical significance unless it undergoes torsion, which can lead to acute pain and necessitate surgical intervention, as seen in a recent case report of a 13-year-old girl with acute abdominal pain due to torsion of the hydatid of Morgagni 1.
Clinical Significance
The hydatid of Morgagni is an embryological remnant that develops from the Müllerian ducts in females and the Wolffian ducts in males, and is typically asymptomatic, but can occasionally undergo torsion, leading to acute pain, as reported in a study of 22 cases of torsion of the hydatid of Morgagni, where the typical symptomatology was the sudden appearance of acute pain, located most frequently in the left side, accompanied by vegetative symptoms 2.
Diagnosis and Treatment
The diagnosis of torsion of the hydatid of Morgagni can be challenging, but it is essential to consider this pathology in the differential diagnosis of acute abdomen in females, as emphasized in a recent case report and literature review 1, and surgical intervention may be necessary to relieve pain and prevent complications, as seen in a study of 6 cases of torsion of Morgagni's hydatid, where surgical treatment was the only way of overcoming the pain, confirming the diagnosis, and preventing the risk of secondary testicular atrophy 3.
Fertility Implications
The hydatid of Morgagni may also be a possible underestimated cause of unexplained infertility, as suggested by a study of 213 patients with unexplained infertility, where the pregnancy rate was higher in the group that underwent laparoscopic excision of the hydatid of Morgagni compared to the control group 4, and the bilaterality and fimbrial location of the hydatid of Morgagni were found to be the most significant characteristics impeding pregnancy.
Key Points
- The hydatid of Morgagni is a benign, pedunculated, cystic structure that is usually of no clinical significance unless it undergoes torsion.
- Torsion of the hydatid of Morgagni can lead to acute pain and necessitate surgical intervention.
- The diagnosis of torsion of the hydatid of Morgagni can be challenging, but it is essential to consider this pathology in the differential diagnosis of acute abdomen in females.
- The hydatid of Morgagni may be a possible underestimated cause of unexplained infertility, and laparoscopic excision of the hydatid of Morgagni may improve pregnancy rates in affected patients.