CTICasesIncarcerated/Ischemic Morgagni Hernia (Recurrent)
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Imaging findings
Current chest CT reveals a large, heterogeneous, predominantly fat-attenuation lesion anteriorly, identified as a Morgagni hernia. Compared to a prior CT, there is new inflammation within the herniated fat, reactive fluid, and some anastomoses, suggestive of ischemia. A prior CT from 2012 also showed inflammation, indicating a recurrent problem. Sagittal views highlight the narrow diaphragmatic opening.
Key takeaways
Morgagni hernias can present with acute chest pain, mimicking pulmonary embolism. Incarceration and ischemia of herniated fat are critical complications, especially during pregnancy due to increased intra-abdominal pressure. Imaging findings of inflammation within the herniated fat and reactive fluid are key indicators of incarceration/ischemia. Such hernias can intermittently reduce and recur.
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