Morgagni’s diaphragmatic hernia with Large ASD SECONDUM AND SEVER PHT mimicking a severe congenital heart disease in a newborn and cause delayed diagnosis of Morgagni’s diaphragmatic hernia . a case report

Abstract

  Morgagni hernia is a rare diaphragmatic hernia usually due to congenital defects in the

diaphragm. It is rarely associated with cardiac anomalies, most commonly atrial  small(ostium secundum) or ventricular septal defects. We report a rare case of Morgagni hernia occurring in association with Large ASD SECONDUM AND SEVER PHT mimicking a severe congenital heart disease in a newborn  and the lack of  awareness of the delayed presentation of Morgagni’s diaphragmatic hernia  cause  delayed of  diagnosis 

clinical discussion:  0ur patients . an one  month  old girl , present with cyanosis and shortness of breath admitted were admitted with complaints of chronic cough and repeated chest infections treated accordingly and discharge in good condition .Readmitted after 1 week with similar presentation but her symptoms get worse by time ,patient admitted to PICU as aspiration Pneumonia, patient during the admission diagnosed with Congenital heart disease large ASD ( ostium secundum  ) AND SEVER PHT,by echocardiography .she was stil lethargic hypotonic, low birthweight , she had intermittent cyanosis inspit treating the chest infection was investigated theoral, later she was diagnosed with Morgagni Hernia after repeating CT chest with contrast  two times  . Repair of hernia was done and out come was good inspite she was diagnosed late at age of 2 years. pulmonary hypertention treated ASD closure by double  device

• Conclusion:


• Morgagni’s CDH is a rare malformation, which is difficult  to diagnose by even the most experienced physicians.


• compression of the heart   by the bowel might have led to the incorrect diagnosis of   congenital heart disease. Even in this era of highly sophisticated diagnostic tools,


• A missed diagnosis can lead to life-threatening complications such as   obstruction or strangulation which warrants early surgical intervention