CTICasesPost-Traumatic Diaphragmatic Hernia with Fat Herniation
Imaging findings
A radiograph showed a rounded, low-density lesion with an incomplete border sign along the left lower hemithorax, anterior along the left heart border. CT confirmed the lesion to be fat herniating through a small, sharply marginated defect in the anterior diaphragm, not centered on the central tendon (the typical location for a Morgagni hernia), with otherwise clean surrounding tissue and no history available given the patient was seen as an outpatient.
Key takeaways
A focal, sharply defined diaphragmatic defect with fat herniation that is not centered on the central tendon should raise suspicion for a post-traumatic (including remote penetrating trauma such as a stabbing) diaphragmatic hernia rather than a Morgagni hernia, particularly when the defect appearance and location are atypical for the usual congenital anteromedial Morgagni defect.
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