A RARE PRESENTATION OF MORGAGNI'S HERNIA AS MEDIASTINAL MASS

Abstract

INTRODUCTION Morgagni's hernia is a
congenital herniation of abdominal viscera
into the thoracic cavity through a
retrosternal diaphragmatic defect.CASE
PRESENTATION Asymptomatic 44-year
-old woman underwent master health
checkup. On routine chest radiography,
mass lesion was found in the thorax adjacent
to the heart on right side. CT chest
showed poorly marginated para-cardiac
lesion predominantly consisting of fat
with dense linear septations with mass in
contact with anterior chest wall, lung
margins are clearly demarcated. The
probable diagnosis were in favour of
ParacardiaclipomaThymolipoma. The
results of CT guided biopsy were inconclusive.
Based on investigations, the
probable diagnosis being thymolipoma, a
median sternotomy approach was
planned. By median sternotomy approach,
a well encapsulated mass was
found in the anterior mediastinum which
was found to reduce on handling. The
sac was opened and the content was
omentum. The omentum was reduced.
The diaphragmatic orifice was visualised
and the defect was on the left side. Repair
was done with Prolene mesh and fixed with
1 prolene sutures. CONCLUSION This is a
case of adult Morgagni hernia presented as
right sided mediastinal mass which needs
a high index of suspicion when assessing
patients with asymptomatic mediastinal
mass. A missed diagnosis can lead to lifethreatening
complications such as obstruction
or strangulation which warrants early
surgical intervention.