Morgagni Hernia in an Adult: a Forgotten Cause of Epigastric Pain

A 73-year-old male presented to the emergency department with a 4-day history of severe constant epigastric pain. A cardiac cause was ruled out. A chest X-ray was reported as a large eventration of right diaphragm (Fig. 1). The patient was given a presumptive diagnosis of “duodenitis” and commenced on a trial of proton pump inhibitors. After 6 weeks, the pain returned and a computed tomography (CT) scan of the abdomen revealed a Morgagni hernia with incarcerated, but not obstructed, transverse colon (Fig. 2). The patient was referred to an upper GI surgeon, and an elective laparoscopic repair occurred shortly thereafter. The transverse colon was reduced under vision...