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A huge Morgagni hernia with compression of the right ventricle

Ciancarella, Paolo (Department of Radiology and Bioimaging, Bambino Gesù ) ; Fazzari, Fabio (Children Hospital-IRCCS, Piazza di Sant'Onofrio 4, 00165 Rome, Italy ) ; Montano, Valentina (Division of Cardiology II, Department of Internal Medicine and Cardiovascular Diseases, University Hospital “Paolo Giaccone”, Via del vespro 129, 90127 Palermo, ItalybItaly ) ; Guglielmo, Marco (Pediatric Urological Unit, Department of Sciences for Health Promotion and Mother-Child Care “G. D'Alessandro”, University Hospital “Paolo Giaccone”, Via Giordano 3, 90127 Palermo, ItalycItaly ) ; Pontone, Gianluca (Centro Cardiologico Monzino, IRCCS, Via Carlo Parea 4, 20138 Milan, ItalydItaly ) ;
  • 초록  

    Abstract A 21 year old male with no relevant medical history presented to our Institution for further assessments of a right paracardiac mass founded on a chest X-ray. Chest computed tomography revealed a wide median defect of the diaphragm at the level of xiphoid process of the sternum, with the herniation of omental fat tissue in the mediastinum. Cardiac magnetic resonance confirmed the presence of a huge hernia originating from the foramen of Morgagni (sterno-costal hiatus), displacing the heart leftwards and posteriorly and compressing the right ventricle (RV), giving to it a tubular shape.The signal characteristics were typical of fat tissue, with hyperintense signal in T1 and T2 weighted black blood images and homogeneus signal suppression on STIR T2 black blood images. Short axis real time cine images, performed during deep inspiration, showed an early diastolic ventricular septal bounce, with flattening of the interventricular septum during mid-late diastole: they represented signs of diastolic dysfunction of the right ventricle, resembling a sort of “pseudo-constrictive” pathophysiological model. The patient was thus referred to surgical repair of the diaphragmatic defect.


  • 주제어

    Morgagni hernia .   Heart compression .   Diastolic dysfunction .   Cardiac magnetic resonance .   Computed tomography.  

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