Presentation
Chronic chest discomfort. No history of trauma.
Patient Data
Heterogenous structure of mottled air and soft tissue density is seen overlying the anteromedial aspect of the right hemithorax and the right side of the heart, above the level of the diaphragm with poor delineation of the adjacent diaphragm, likely represents herniated bowel.
No lung lesions. Minimal left pleural effusion/thickening. No cardiomegaly. No hilar enlargement. No significant osseous abnormality.
Case Discussion
Considering the clinical scenario, imaging features are compatible with a Morgagni hernia containing bowel loops. A Morgagni hernia is a type of congenital diaphragmatic hernia through the foramen of Morgagni which is at the anteromedial aspect of the diaphragm usually on the right side.
Morgagni hernia is less common and presents later in life compared with Bochdalek hernia. Bochdalek hernia is the most common type of congenital diaphragmatic hernia (based on location), commonly occurring through a posterolateral defect on the left side.