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An Unusual Case of Huge Morgagni Hernia: The Need for High Index of Suspicion

Awajimijan Nathaniel Mbaba, Rufus Abam and Michael Promise Ogolodom

Morgagni hernia is an uncommon form of congenital diaphragmatic hernia. They are mostly asymptomatic but may sometimes present with non-specific symptoms. The absence of typical clinical manifestation in cases of Morgagni hernia leads to delay in diagnosis and subsequent treatment. Delayed or Missed diagnosis can lead to considerable morbidity and even mortality. We present an unusual case of huge Morgagni hernia in apparently healthy-looking 4-month old male child with fast breathing and intermittent cough being investigated for bronchopneumonia unresponsive to antibiotic therapy. Plain radiograph of the chest picked up the pathology and was confirmed with ultrasound. A high index of suspicion is required when assessing a chest radiograph with intrathoracic cystic lesions especially in a patient with respiratory symptomatology and occasionally symptoms suggestive of gastrointestinal obstruction.

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