CTICasesMorgagni Hernia Containing Omental Fat
[...]. Morgagni Hernia Containing Omental Fat. CTICases. Published October 1, 2026. https://cticases.com/c/7t7fz
Imaging findings
A patient seen for chest pain has a mass at the right anterior cardiophrenic angle next to the mediastinum on the radiograph. Its upper edge is convex. CT shows the mass is made of fat. Axial and coronal images show the vessels passing through only faintly, but a sagittal reconstruction clearly shows a vessel coursing through the anterior diaphragm into the fat, which confirms herniated omental fat rather than the patient's own pericardial fat pad.
Key takeaways
Prominent pericardial fat at the cardiophrenic angle usually has a concave upper edge. A convex upper edge points to something else, most often a Morgagni hernia or a pericardial cyst. When a cardiophrenic angle mass is fat, look for omental vessels crossing the anterior diaphragm to prove it is a hernia, and check sagittal reformats, which can show this best.
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