Morgagni hernia: An unexpected cause of respiratory complaints and a chestmass

Morgagni hernia (MH) is the least common type of congenital diaphragmatic h ernias. Although its course is often asymptomatic, it may be associated wit h various respiratory and gastrointestinal symptoms. We describe 7 children with MH during a 5-year period in three pediatric centers in Turkey. All children had acute or chronic respiratory symptoms; cough was the most frequent. The diagnosis was made by posterior-anterior (PA) and lateral che st X-rays. The PA chest X-rays showed a homogenous mass in 2 and a gas-fill ed cystic image in 3 children in the right cardiophrenic angle. A retrocard iac homogeneous density in one child, and bilateral consolidation in lower lung areas in another child were also seen. All lateral chest X-rays showed gas-filled bower loops above the diaphragm. The diagnosis was confirmed by barium-contrast radiograph. Four patients had five additional anomalies, i .e., ventricular septal defect, right inguinal hernia, congenital hip dislo cation, pectus carinatum, and obstruction of the uretero-pelvic junction. A ll of the hernias were repaired by an abdominal approach. There were no com plications or recurrences during follow-up. In conclusion, MH should be considered in the differential diagnosis of cas es of long-standing respiratory symptoms and/or when an unexplained radiolo gical image, especially on the right cardiophrenic area, is present. (C) 20 00 Wiley-Liss, Inc.