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Unilateral diaphragmatic agenesis precluding laparoscopic cholecystectomy
A Wakai1, D C Winter, G C O'Sullivan
1Department of Surgery, Mercy Hospital and University College, Cork, Ireland. wakai@indigo.ie
Background:
Complete absence of a hemidiaphragm or diaphragmatic agenesis in adulthood is rare with only one previous report in the literature. Its significance in relation to performing laparoscopic procedures has not been documented previously.
Methods:
We report a case of previously undiagnosed diaphragmatic agenesis in adulthood precluding laparoscopic cholecystectomy and comprehensively review the literature for papers relevant to diaphragmatic agenesis in adulthood.
Results:
Diaphragmatic agenesis in adulthood may complicate and preclude laparoscopic cholecystectomy. The principles of investigation and management of diaphragmatic agenesis complicating laparoscopic surgery are discussed.
Conclusions:
In adults with diaphragmatic agenesis and intrathoracic abdominal viscera precluding laparoscopic cholecystectomy, conservative management is recommended.