Congenital Morgagni hernia: Misleading images and delayed diagnosis
Suresh CHANDRAN 1, Neha JAIN 1, Aftab RANA 2, Anitha MADAYI 1
1 KK Women’s and Children’s Hospital, Singapore and 2 Department of Paediatric, RIPAS Hospital, Bandar Seri Begawan, Brunei Darussalam
Diaphragmatic hernia of the Morgagni type is relatively rare. We report the case of a term 10-day-old female infant admitted through the emergency department with symptoms of lethargy, poor feeding, and vomiting. Her general physical examination was normal except for weight loss of 450gm and minimal sub-costal indrawing, whilst normal breath sounds and heart sounds on auscultation. Sepsis markers were negative. Chest radiography revealed non-specific opacities in the right middle and lower zones. A diagnosis of pneumonia was made and the patient was admitted for parenteral antibiotics. The patient remained symptomatic after seven days of intravenous antibiotics and a repeat chest radiograph showed a suspicious radiolucent shadow in the right lower lobe. An upper gastrointestinal contrast study confirmed the diagnosis of right-sided congenital Morgagni hernia. Subsequently the diaphragmatic hernia was repaired and the infant made a quick recovery.
Keywords: Congenital hernia, diaphragmatic hernia, upper gastrointestinal contrast study
Correspondence author: Suresh CHANDRAN. Department of Neonatology, KK Women’s and Children’s Hospital, 100 Bukit Timah Road, Singapore 229899. E mail: firstname.lastname@example.org
Brunei Int Med J. 2015; 11 (1): 45-48