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CLINICAL IMAGE
Year : 2020  |  Volume : 152  |  Issue : 7  |  Page : 52

Left Morgagni hernia with sequestered intrathoracic omental cyst


Department of Pediatric Surgery, St. John's Medical College Hospital, Bengaluru 560 034, Karnataka, India

Date of Submission17-Oct-2019
Date of Web Publication25-May-2021

Correspondence Address:
Shalini Hegde
Department of Pediatric Surgery, St. John's Medical College Hospital, Bengaluru 560 034, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmr.IJMR_1803_19

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How to cite this article:
Hegde S, Shubha A M. Left Morgagni hernia with sequestered intrathoracic omental cyst. Indian J Med Res 2020;152, Suppl S1:52

How to cite this URL:
Hegde S, Shubha A M. Left Morgagni hernia with sequestered intrathoracic omental cyst. Indian J Med Res [serial online] 2020 [cited 2021 Jul 29];152, Suppl S1:52. Available from: https://www.ijmr.org.in/text.asp?2020/152/7/52/316733

Consent to publish clinical information and images obtained from patient's parent.


A four month old female infant presented to the Paediatric Emergency of St. John's Medical College Hospital, Bengaluru, India, in September 2018, with excessive crying for the past four days. The child had tachycardia (110/min), tachypnoea (61/min) and reduced left-sided air entry. Chest X-ray [Figure 1]A showed atypical left effusion. The child rapidly deteriorated over the next 12 h, requiring mechanical ventilation. Contrast-enhanced computed tomography of the chest [Figure 1]B showed fat stranding within the fluid collection [Figure 1]C. An emergency left thoracotomy was done [Figure 2]A which revealed a Morgagni hernia, sequestered omental cyst [Figure 2]B and herniated transverse colon. The cyst was decompressed [Figure 2]C, omentum excised and hernia repaired. The child recovered and is well on one year follow up. The sequestration cyst was probably formed due to partial strangulation of the omentum. The increasing size led to infarction and sudden deterioration.
Figure 1: (A) X-ray showing atypical effusion (arrow). (B) Computed tomography of the chest showing large collection in the left thorax with defect in diaphragm anteromedially (arrow). (C) Axial cut of computed tomography of the chest showing fat/omentum within the collection (arrow).

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Figure 2: (A) Intraoperative picture showing cyst bulging as thorax is opened (arrow). (B) Intraoperative picture showing decompressed cyst with omentum inside and infarcted omentum before omentectomy.

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Conflicts of Interest: None.


    Figures

  [Figure 1], [Figure 2]



 

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