Case Reports Korean Circulation J 1998;28 4 : 심낭지방종으로오진했던 Hiatal Hernia 와 Morgagni Hernia 김남호 1 정명호 1, 2 박우석 1 김준우 1 김성희 1 김주한 1 배열 1 안영근 1 서정평

Size: px

Start display at page:

Download "Case Reports Korean Circulation J 1998;28 4 : 심낭지방종으로오진했던 Hiatal Hernia 와 Morgagni Hernia 김남호 1 정명호 1, 2 박우석 1 김준우 1 김성희 1 김주한 1 배열 1 안영근 1 서정평"

효주 섭
5 years ago
Views:

1 Case Reports Korean Circulation J 1998;284: 심낭지방종으로오진했던 Hiatal Hernia 와 Morgagni Hernia 김남호 1 정명호 1, 2 박우석 1 김준우 1 김성희 1 김주한 1 배열 1 안영근 1 서정평 1 박종철 1 차광수 1 박주형 1 조정관 1, 2 박종춘 1, 2 강정채 1, 2 Two Cases of Sliding Hiatal and Morgagni Hernia Mimicking Pericardial Lipomas Nam Ho Kim, MD 1, Myung Ho Jeong, MD 1, 2, Woo Suck Park, MD 1, Joon Yoo Kim, MD 1, Sung Hee Kim, MD 1, Ju Han Kim, MD 1, Youl Bae, MD 1, Young Keun Ahn, MD 1, Jeong Pyeong Seo, MD 1, Jong Cheol Park, MD 1, Kwang Soo Cha, MD 1, Joo Hyung Park, MD 1, Jeong Gwan Cho, MD 1, 2, Jong Chun Park, MD 1, 2 and Jung Chae Kang, MD 1, 2 1 Department of Cardiovascular Medicine, Chonnam University Hospital, Kwangju, 2 The Research Institute of Medical Sciences, Chonnam National University, Kwangju, Korea ABSTRACT The differential diagnosis between pericardial and non-cardiac masses may be sometimes difficult in the evaluation of chest mass adjacent to the heart. One misdiagnosed case of non-cardiac mass as a pericardial mass turned out to be a hernia. When the contents of hernia originate from the gastrointestinal tract, the diagnosis is made easily by air-fluid shadow on plain chest roentgenogram. Morgagni hernia is usually detected on plain chest roentgenograms as a smooth, supradiaphragmatic shadow at the right pericardiophrenic angle. In the case of Morgagni hernia, in which the contents are only the omentum, it is necessary to differentiate the hernia from mediastinal fatty tumors. We report two cases of hiatal and Morgagni hernia containing omentum which were misdiagnosed as pericardial masses. Korean Circulation J 1998;284: KEY WORDSHiatal hernia Morgagni hernia Pericardial mass. 서 론 632

2 증례 증례 1 증례 2 고안 633

사하게 관찰되는 식도 열공 헤르니아 5예를 보고하였 ber view에서 좌심방의 전부 또는 대부분을 가득 채우 9-13) 에 의해서 보고된 바 는 경계가 불명확한

D Cruz 등 은 심초음파도상 심첨부 4 cham- 으며, 때때로 좌심방에서 인접한 우심방까지 가로지르 고, 그 이후로 소수의 보고자 14

(A) Chest posteroanterior and left lateral radiogram showing mass shadow (arrow) in right

(B) Non-contrast enhanced CT utilizing mediastinal windows demonstrates heterogeneous

3 사하게 관찰되는 식도 열공 헤르니아 5예를 보고하였 ber view에서 좌심방의 전부 또는 대부분을 가득 채우 9-13) 에 의해서 보고된 바 는 경계가 불명확한 커다란 고형 종괴로 나타날 수 있 있다. D Cruz 등 은 심초음파도상 심첨부 4 cham- 으며, 때때로 좌심방에서 인접한 우심방까지 가로지르 고, 그 이후로 소수의 보고자 14) A B Fig. 1. Hiatal hernia. (A) Chest posteroanterior and left lateral radiogram showing mass shadow (arrow) in right cardiophrenic angle and both pleural effusion. There is no air-fluid level on chest X-ray. (B) Non-contrast enhanced CT utilizing mediastinal windows demonstrates heterogeneous structure extending into the region of the retrocardial cavity. The hernia contains a portion of the stomach. (C) Pharyngoesophagogram showing hiatal hernia with thickened esophageal mucosal folds. 634 C Korean Circulation J 1998;28(4):

4 A B C D Fig. 2. Morgagni hernia (A) Chest X-ray showing cardiomegaly and soft mass in right lower medial chest. (B) Chest CT scan showing about 6 7 cm pericardial fat in right anterior cardiophrenic region. (C) Transthoracic biopsy demonstates fat tissues suggesitve of pericardial lipoma. (D) Gross finding of postsurgical biopsy specimen showing omentum. 635

5 636 요 중심단어 REFERENCES 1) Silverman NA. Primary cardiac tumors. Ann Surg ) Bear PB, Moodie DS. Malignant primary cardiac tumors; The Cleveland Clinic Experience, 1956 to Chest ) Tazelaar HD, Locke TJ, McGregor C. Pathology of surgically excised primary cardiac tumors. Mayo Clin Proc ) Hur SH, Kim KS, Kim YN, Shin KM, Han SW, Kang MS, Kim KB. The characteristics of primary cardiac tumors occured in Korean people. Kor J Echocardiogr ) An WS, Park HS, Kam DH, Son JW, Dho HK, Kim MH, Kim YO, Kim JS. Echocardiographic findings in cardiac tumors. Kor J Echocardiogr 1985; ) Kang MS, Chung KY, Cho BK, Hong SN, Soh DM. Surgical treatment of primary heart tumor report of 22 cases. Korean J Thoracic Cardiovas Surg ) Amparo EG, Higgins CB, Farmer D, Gamsu G, McNamara M. Gated MRI of cardiac and paracardiac masses initial experience. AJR ) Nishimura RA, Tajik AJ, Schattenberg TT, Seward JB. Diaphragmatic hernia mimicking an atrial mass a twodimensional echocardiographic pitfall. J Am Coll Cardiol ) Baerman JM, Hogan L, Swiryn S. Diaphragmatic hernia producing symptoms and signs of a left atrial mass. Am Heart J ) D Cruz IA, Hoffman PK, Ewald FW. Echocardiography of posterior mediastinal masses encroaching on the left atrium. Echocardiography ) Mosvovitz HD, Jacobs LE, Mosvovitz C, Kotler MN, Ioli AW. Transesophageal echocardiographic evaluation of a transthoracic echocardiographic pitfall a diaphragmatic hernia mimicking a left atrial mass. J Am Soc Echocardiogr 약 Korean Circulation J 1998;284:

6 12) Bowles MH, Lipman R. Hiatal hernia the Xfactor in transesophageal echocardiography. J Am Soc Echocardiogr ) Yang SS, Wagner P, Dennis C. Hiatal hernia masquerading as left atrial mass. Circulation ) D Cruz IA, Hancock HL. Echocardiographic characteristics of diaphragmatic hiatus hernia. Am J Cardiol ) Winkler M, Higgins CB. Suspected intracardiac masses evaluation with MR imaging. Radiology ) Comer PT, Clagett OT. Surgical treatment of the for a- men of Morgagni. J Thorac Cardiovasc Surg ) Collie DA, Turnbull CM, Shaw TR, Price WH. Case report MRI appearances of left sided Morgagni hernia containing liver. Br J Radiol ) Sekiguchi Y, Shimura S, Takishima T. Intrapleural omentum simulating pleural effusion. Chest ) Valases C, Sills C. Case reportanterior diaphragmatic hernia hernia of Morgagni. New Jersey Med ) Kamiya N, Yokoi K, Miyazawa N, Hishinuma S, Ogata Y, Katayama N. Morgagni hernia diagnosed by MRI. Jpn J Surg

(

317 318 319 320 1 3 5 5 5 5 2 321 : 1.,,,,, 06 2. X-ray beam penetration (density) (contrast) 03 3. patch coating, precipitation, flaking 03 4. centering 03 5. Esophagus, cardia, fundus, body, angle, antrum,