IS Case 303: Morgagni hernia
Imaging Sciences URMC 2009
Publication Date: 2009-08-06
History
Patient is a 17-year-old female presenting to the Emergency Department as a driver in a motor vehicle crash
Findings
Chest x-ray revealed elevation of the right hemidiaphragm consistent with diaphragmatic hernia, which could represent a congenital hernia but could not exclude traumatic diaphragmatic hernia. CT confirmed that the hernia was indeed congenital as there was no evidence of diaphragmatic rupture.
Diagnosis
Discussion
Morgagni hernias represent 2–5% of all diaphragmatic hernias. These develop when a defect develops in the septum transversum. They are lateral retrosternal in location, typically on the right, and associated with ipsilateral pulmonary hypoplasia less severe than that seen with Bochdalek hernias. They are more common in women and are usually not discovered until adulthood when the patient may present with vague abdominal pain, vomiting, growth failure, chest pain, dyspnea, cough, and recurrent respiratory infections. On chest x-ray, a mass can be seen in the anterior mediastinum that may be solid or gas-filled with loops of bowel and better appreciated on the lateral view.
References
- Schwartz MW. The 5-Minute Pediatric Consult. 5th Ed., Lippincott Williams & Wilkins, 2008.
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