PMC8315875_01
CT scan: colon and omentum lodged within the right chest (white arrows).
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The CT scan showed a large Morgagni-type hernia with the entire right hemicolon, parts of the transverse colon and terminal ileum, and ample omentum trapped in the chest (Figure 1), causing atelectasis of the right lower lobe.
Colonoscopy (endoscope entered chest through the Morgagni hernia during exam). Mass in ascending colon (black arrows).
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He had a positive stool guaiac test and underwent a colonoscopy showing a large mass in the right colon (Figure 2).
Intraoperative findings. (a) Large right anterior diaphragmatic defect: the contents are gently reduced (black arrows). (b) A Phasix Mesh (white arrows) is placed to reinforce the hernia closure.
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fig3
The hernia contents were gently reduced from the mediastinum (Figure 3(a)). As this was a clean contaminated case, a 10 x 7 cm bioabsorbable Phasix  ST Mesh (Bard, Warwick, RI, USA) was placed to protect the reconstruction (Figure 3(b)); and the mesh was extraperitonealized using the dorsal flap of the hernia sac.