Congenital diaphragmatic hernia: Morgagni type

Case contributed by Dr Shailaja Muniraju

Presentation

Respiratory distress.

Patient Data

Age: 3 years
Gender: Female
Modality: X-ray

Well demarcated smooth homogenous right para-cardiac mass noted.

The rest of the lungs have patchy non-homogenous air space opacities, suggestive of bronchopneumonia.

Two days later

Modality: X-ray

The right sided paracardiac mass now shows central lucency and this lucency appears to have intra-abdominal continuation.

The lucent area in the left upper abdomen appears to be colon.

Provisional diagnosis of diaphragmatic hernia, possibly with stomach within the sac, can be formed.

The bilateral air space opacities appears worse.

Modality: Barium

Naso-gastric tube is sited in stomach lumen.

There is intra-thoracic herniation of stomach via anterior diaphragmatic defect.

Chest xray findings are confirmed. 

CT confirms the intra-thoracic stomach. No diaphragmatic continuity.

Confirmatory diagnosis is Morgagni subtype of congenital diaphragmatic hernia with stomach and omentum in the sac.

Bilateral air space opacities persist.

Intra-operative findings:

Laparotomy and repair was performed. There was a 3 x 2 cm sized anterior and midline diaphragmatic defect. The stomach was pulled down into the abdominal cavity and it was repaired with Prolene interrupted suture.

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Case Information

rID: 50553
Case created: 11th Jan 2017
Last edited: 18th Jan 2017
Inclusion in quiz mode: Included

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