대한흉부영상의학회 Korean Society of Thoracic Radiology

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대한흉부영상의학회 Weekly Case 검색
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Weekly Chest CasesArchive of Old Cases

Case No : 326 Date 2004-01-24

  • Courtesy of Yu-Whan Oh, M.D. / Korea Ubniversity Anam Hospital, Seoul, Korea
  • Age/Sex 76 / F
  • Chief ComplaintIncidental abnormality on a chest radiograph
  • Figure 1
  • Figure 2
  • Figure 3

Diagnosis With Brief Discussion

Diagnosis
Morgagni's hernia
Radiologic Findings
Chest radiograph shows well-defined opacity in right cardiophrenic angle. Sequential CT scans shows paracardiac mass composed of fatty tissue, which is continuous with fat below the diaphragm. Focal defect is seen in anterior portion of diaphragm and curvilinear densities within fatty mass
Brief Review
The foramen of Morgagni’s hernia is the least common of the diaphragmatic hernias, comprising 3% of surgically treated hernias. Morgagni’s hernia is rare in adults and occurs more often in children, in whom herniation of bowel is more common. Radiographically, Morgagni’s hernias generally present as homogeneous masses in the right cardiophrenic angle. Though colonic herniation was rare, the characteristic deformity and upward displacement of the transverse colon was thought to be highly suggestive of Morgagni’s hernia. With the advent of CT, the diagnosis can be made with confidence of in the setting of a fat-containing cardiophrenic angle mass with associated omental or mesenteric vessels. MR imaging reveals the fatty nature of the mass, defines the omental vessels, and can precisely define the diaphragmatic defect.
References
1. Gilkeson RC, Basile V, Sands MJ, Hsu JT. Chest case of the day: Morgagni's hernia.AJR Am J Roentgenol. 1997 Jul; 169(1): 266, 268-70

2. Kamiya N, Yokoi K, Miyazawa N, Hishinuma S, Ogata Y, Katayama N. Morgagni hernia diagnosed by MRI. Surg Today. 1996; 26(6): 446-8.
Keywords
Diaphragm, Congenital,

No. of Applicants : 38

▶ Correct Answer : 24/38,  63.2%
  • - Akdeniz Universty School of Medicine, Antalya, Turkey Gokhan Arslan
  • - Annecy Hospital, France Gilles Genin
  • - Centre Hospitalier d'auxerre, France Riad Khatab
  • - CH Lyon sud, France Xavier Riviere
  • - Chonnam National University Hospital, Korea Nam Yeol Yim
  • - CHU Nancy-Brabois, France Denis Regent
  • - CIM Saint Dizier, France JC Leclerc
  • - Clinic 1, Moscow, Russia Lepikhina Dasha
  • - Escola Paulista de Medicina, Fleury, Sao Paulo - Brazil Gustavo Meirelles
  • - Ev. Krkhs. Hubertus, Berlin, Germany Michael Weber
  • - Jeju Hanmaeum Hospital, Korea Kwon Hyoung Kim
  • - Korea University Guro hostpital, Korea Ok Hee Woo
  • - Kyung Hee university medical center, Korea Sang-Won Kim
  • - Homs National Hospital, Homs, Syria Rami Abou Zalaf
  • - Hospital Donostia Aitor Tilla
  • - Hopital europeen Georges Pompidou , France Rached Triki
  • - Incheon Sarang Hospital, Korea Jung Hee Kim
  • - Mallinckrodt Institute of Radiology, USA Jin Mo Goo
  • - Ondokuz Mayis University, Samsun, Turkey Cetin Celenk
  • - Samsung Medical Center, Korea Seo-Hyun Kwak
  • - Samsung Medical Center, Korea Yeon Joo Jeong
  • - Seoul National University Hospital, Korea Eun-Ah Park
  • - Shin Kong Wu Ho-Su Memorial Hsopital, Taipei, Taiwan Chen-Chun Lin
  • - Social Security Hospital, Ankara, Turke Meric Tuzun
▶ Semi-Correct Answer : 3/38,  7.9%
  • - Dong-A University Hospital, Korea Ki-Nam Lee
  • - Hangang SacredHeart Hospital, Korea Eil Seong Lee
  • - Kyunghee University Hospital, Korea Kyung Ran Ko
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Current Editor : Sang Young Oh, M.D., Ph.D Email : sangyoung.oh@gmail.com

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