Presentation
Patient with a recent history of blunt chest trauma. Chest X-ray was done to rule out rib fracture
Patient Data
Chest x-ray demonstrates bubble-like lucencies that appear like bowel within chest projecting through the heart shadow just behind the sternum. Mediastinal shift to the contralateral side is also seen.
Upper gastrointestinal series confirms the presence of bowel loops within the anterior chest
Case Discussion
Morgagni`s hernia (retrosternal hernia) is a rare type of DH that arises from anterior medial septum transversum defect due to failure of closure of the pars sternalis with the seventh costochondral arch. The anatomic defect is also known as Larrey’s space caused by the passage of the superior epigastric vessels. Although MH usually lies on the right side and slightly posterior to the xiphoid process, it may be found on the left side or bilaterally. The presence of the pericardium has been proposed as a barrier against the occurrence of the left-sided hernia. MHs constitute 2–6% of CDH cases and 2–4% of the whole of non-traumatic diaphragmatic hernias in the adult. They have a covering or sac, and the hernia sac frequently contains the omentum, transverse colon, and rarely stomach or liver. Malrotation or malfixation of the intestine may be found in association with MH.
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