Images of Memorable Cases: Case 53 Chest radiographs of an asymptomatic 36-year-old man with normal physical findings. 53. Foramen of Morgagni hernia The radiographs show that the large right paracardiac mass represents bowel that has herniated anteriorly into the chest, presumably through a congenital diaphragmatic defect involving the Foramen of Morgagni. A computed tomographic scan (image below) confirmed the diagnosis. Such herniation typically occurs on the right but can be left-sided or bilateral. Surgical repair is recommended in most cases to prevent obstruction or strangulation of the bowel.