CTICasesBilateral Foramen of Morgagni Hernias
Imaging findings
Chest radiograph shows bilateral opacities at the right and left cardiophrenic angles defacing the cardiac borders and diaphragm. CT confirms bilateral anterior diaphragmatic defects through which fat and a portion of colon herniate, consistent with bilateral foramen of Morgagni hernias. Sagittal views confirm bilateral separate defects with preservation of a small central tendon between them, confirming these are two distinct hernias rather than a single large midline defect. Colon is visible passing through each defect.
Key takeaways
Bilateral simultaneous foramen of Morgagni hernias are rare but do occur, and imaging with CT including sagittal reformats can confirm the presence of two separate defects distinguished by a preserved central tendon between them rather than a single large midline defect. The bilateral nature is more easily appreciated on coronal views where fat and bowel are seen entering each cardiophrenic angle. These hernias are usually incidental and congenital in nature, containing fat or colon.
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