CTICasesCongenital Airway and Vascular Anomalies with Morgagni Hernia
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Imaging findings
Chest radiography shows a large anterior-inferior mediastinal mass that CT reveals to be a large, fat-containing Morgagni hernia. Multiplanar CT reconstructions also demonstrate a constellation of congenital airway and vascular anomalies: a small, aborted tracheal bronchus; diffuse, severe intrathoracic tracheal stenosis suggestive of complete tracheal rings; absent right main bronchus with the right upper lobe bronchus and bronchus intermedius arising directly from the distal trachea; a duplicated left brachiocephalic vein draining into the coronary sinus; and a single right pulmonary vein.
Key takeaways
Congenital airway anomalies, such as tracheal stenosis with complete rings, bronchial branching variations, and tracheal bronchi, are frequently associated with concurrent vascular and venous anomalies. Patients with these complex abnormalities can remain completely asymptomatic into adulthood, with the lesions discovered incidentally during imaging for unrelated issues, such as a trauma or a Morgagni hernia.
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