Giant Morgagnian hernia masquerading as pleural effusion.

Morgagnian hernia is a congenital diaphragmatic hernia which occurs through anteromedial defect in the diaphragm. A 58-year-old lady was referred for surgical management of chronic massive pleural effusion. High-resolution CT scan of the chest demonstrated an anteromedial defect in the diaphragm and with contents being colon and great omentum. She required anterolateral thoracotomy and reduction of hernia with repair of formen of Morgagni with prolene mesh. Blind needle aspiration would have punctured the colon; hence the case is being reported to highlight the necessity of CT scan/ultrasound of chest in investigating a chronic massive pleural effusion much before a needle is put for aspiration blindly.