Morgagni hernia in adult: A case report

Introduction and Importance: Morgagni Hernia is a congenital diaphragmatic hernia, typically diagnosed in neonates or infants, but in rare cases, it can present in adults. This condition results from a developmental defect in the diaphragm during embryogenesis, leading to an opening that allows abdominal contents, to herniate into the thoracic cavity. In adults, the presentation is often subtle and may be overlooked until significant symptoms or complications arise. In this case, we report a 50-year-old female with symptomatic Morgagni hernia, highlighting the importance of early recognition and management.
Case Presentation: A 50-year-old female patient with a history of adult-onset asthma presented with recurrent chest symptoms, including persistent cough and shortness of breath. These symptoms had been ongoing for several months, prompting further investigation. A contrast-enhanced CT (CECT) of the chest revealed omental fat herniated into the right hemithorax, confirming the diagnosis of a Morgagni hernia. 
Clinical Discussion: Morgagni hernias are typically diagnosed incidentally on routine chest radiographs when patients are asymptomatic. However, when symptoms do occur, they may mimic various respiratory or gastrointestinal conditions, such as chest pain, cough, or dyspnea, which can be attributed to other more common causes. In the case of adults, the hernia often remains undiagnosed for years or even decades due to the nonspecific nature of the symptoms.
This case represents an adult patient with Morgagni hernia who presented with chest symptoms, a relatively rare but significant clinical presentation. The imaging modality of choice for diagnosing Morgagni hernia is CECT, which allows for precise identification of the herniated contents in the thoracic cavity. Surgical repair of the hernia is advised, even in asymptomatic cases, due to the potential for serious complications such as strangulation or incarceration of the herniated bowel. 
In summary, Morgagni hernia in adults, though rare, should be considered in the differential diagnosis of patients with recurrent chest symptoms, especially when conventional causes of such symptoms have been excluded. Early diagnosis and timely surgical intervention are crucial to prevent complications.