Morgagni hernia

Dr Jeremy Jones et al.

Morgagni hernias are one of the congenital diaphragmatic hernias (CDH), and is characterised by herniation through the foramen of Morgagni. When compared to Bochdalek hernias, Morgagni hernias are:

  • anterior
  • more often right-sided (~90%)
  • small
  • rare (~2% of CDH)
  • at low risk of prolapse

Only ~30% of patients are symptomatic. Newborns may present with respiratory distress at birth similar to a Bochdalek hernia. Additionally, recurrent chest infections and gastrointestinal symptoms have been reported in those with previously undiagnosed Morgagni hernia.

Morgagni hernias most often contains omental fat, but transverse colon (60%) or stomach (12%) may be included within the hernia. 

Associations

Some sources recommend laparoscopic surgical repair, even in asymptomatic patients, to avoid the risk of strangulation of the hernia contents 6.

The main differential diagnosis for Morgagni hernia is a cardiophrenic fat pad. Other cardiophrenic angle lesions can be considered in the differential diagnosis on chest radiograph, although Morgagni hernia is relatively radiolucent compared with other lesions not containing fat.

Focal diaphragmatic eventration may also cause this appearance.

Morgagni hernia may rarely mimic diaphragmatic rupture from trauma, but you would expect to find other supportive signs of chest and/or abdominal trauma. Also diaphragm rupture is most commonly posterior and posterolaterally, rather than anteriorly where Morgagni's foramina are located.

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Article Information

rID: 5772
Section: Pathology
Tag: hernia
Synonyms or Alternate Spellings:
  • Morgagni hernia
  • Morgagni herniation
  • Morgagni's hernia

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