Case Reports Korean Circulation J 1998;284:632-637 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;284:632-637 KEY WORDSHiatal hernia Morgagni hernia Pericardial mass. 서 론 632
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 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):632-637
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
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