A RARE PRESENTATION OF MORGAGNI'S HERNIA AS MEDIASTINAL MASS

INTRODUCTION Morgagni's hernia is a congenital herniation of abdominal viscera into the thoracic cavity through a retrosternal diaphragmatic defect.CASE PRESENTATION Asymptomatic 44-year -old woman underwent master health checkup. On routine chest radiography, mass lesion was found in the thorax adjacent to the heart on right side. CT chest showed poorly marginated para-cardiac lesion predominantly consisting of fat with dense linear septations with mass in contact with anterior chest wall, lung margins are clearly demarcated. The probable diagnosis were in favour of ParacardiaclipomaThymolipoma. The results of CT guided biopsy were inconclusive. Based on investigations, the probable diagnosis being thymolipoma, a median sternotomy approach was planned. By median sternotomy approach, a well encapsulated mass was found in the anterior mediastinum which was found to reduce on handling. The sac was opened and the content was omentum. The omentum was reduced. The diaphragmatic orifice was visualised and the defect was on the left side. Repair was done with Prolene mesh and fixed with 1 prolene sutures. CONCLUSION This is a case of adult Morgagni hernia presented as right sided mediastinal mass which needs a high index of suspicion when assessing patients with asymptomatic mediastinal mass. A missed diagnosis can lead to lifethreatening complications such as obstruction or strangulation which warrants early surgical intervention.