A rare case of left diaphragmatic agenesis in an elderly patient

A 71-year-old man affected by left hemidiaphragmatic agenesis developed late severe constipation and occasional episodes of bowel obstruction. At left subcostal laparotomy, the stomach, transverse colon, splenic flexure, and spleen were located in the left hemithorax. Repair was performed with a 2-mm-thick expanded polytetrafluoroethylene (Gore-Tex) patch secured in place circumferentially as a new diaphragmatic dome. No early major complications and no recurrence at 34 months' follow-up were observed. To the best of our knowledge, this is the oldest treated patient with a true hemidiaphragmatic agenesis and is the eighth case reported in the literature. The use of the ePTFE soft tissue patch, thanks to its strength and pliability, affords good anatomical and functional repair.