A CASE OF MORGAGNI' FORAMEN HERNIA DIAGNOSED PREOPERATIVELY

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  • 術前に診断しえたMorgagni孔ヘルニアの1例

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Abstract

A case of Morgagni's foramen hernia involving only the greater omentum which was preoperativery diagnosed by angiography is reported. A 64-year-old woman was referred to the hospital with a suspicion of having a mediastinal tumor at a mass screening medical examination. Chest x-ray film revealed a fist-sized tumor shadow at a corner of diaphragm in the right heart. Chest CT visualized a tumor shadow of fat density adjacent to the right side of cardiac shadow behind the sternum. On sagittal plane of chest magnetic resonance imaging (MRI), a tumor shadow of fat density which was adjacent to the pericardium and anterior thoracic wall and communicated with the abdomen was confirmed. Morgagni's foramen hernia was suspected, but a possibility of mediastinal tumor could not be ruled out. So an angiography was performed and an omental branch of the right gastroepiploic artery along the tumor shadow was revealed. From these findings, the patient was diagnosed as having Morgagni's foramen hernia containing only the greater omentum and was operated on. At operation, the greater omentum was reduced by an abdominal approach, and the hernial openning was closed after the hernial sac was resected from the abdominal cavity. In the diagnosis of the disease, angiography is very valuable.

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