CTICasesMorgagni Hernia
Imaging findings
Serial chest radiographs in a middle-aged male reveal the sudden, interval development of a well-defined mass-like opacity in the right anterior cardiophrenic angle. Axial and coronal CT reconstructions of the chest confirm a focal defect in the anterior diaphragm through which omental fat herniates into the low anterior mediastinum. Coronal views are particularly useful for delineating the diaphragmatic break and showing abdominal vessels streaming through the defect. A second, larger example in a different patient shows a giant hernia containing a large portion of the colon and omentum.
Key takeaways
Morgagni hernias are congenital diaphragmatic defects located anteriorly and medially, typically on the right side. While they are congenital in origin, they can manifest or acutely enlarge in adulthood due to increased intra-abdominal pressure or physical strain, presenting as an acute change on serial chest radiographs. Coronal and sagittal CT reconstructions are highly effective for confirming the diagnosis by demonstrating the diaphragmatic defect and the herniation of abdominal fat or viscera.
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