TITLE:
Unilateral Diaphragmatic Agenesis with Lung Cyst Herniating into the Abdomen Precluding Diaphragmatic Hernia in an Adult
AUTHORS:
Binay Krishna Sarkar, Krishnendu Chakravorty, Ashis Halder, Paresh Banerjee, Saroja Bharati
KEYWORDS:
Lung Cyst, Absent Hemidiaphragm, Recurrent Respiratory Infection
JOURNAL NAME:
World Journal of Cardiovascular Surgery,
Vol.6 No.11,
November
30,
2016
ABSTRACT: Background: Diaphragmatic agenesis or complete absence of a hemidiaphragm in
adulthood is rare. The significance of presence of a lung cyst occupying the common
thoracoabdominal space lies in the absence of associated diaphragmatic hernia which
has not been documented previously. Case Presentation: We report a case of previously
undiagnosed complete absence of a hemidiaphragm in a 62-year-old male who presented
with recurrent respiratory infection, episodes of nausea and postprandial fullness.
Computed Tomography scan showed a large cyst in relation to the lower lobe of
left lung. During surgery, he was found to have complete absence of a left hemidiaphragm
and a large cyst arising from the lower lobe of left lung occupied the common
thoracoabdominal space. Abdominal viscera were found displaced downwards and
fixed in a thick fibrous membrane. There was no herniation of abdominal organs into
the thoracic cavity after excision of the cyst. The left lung could be fully expanded and
chest was closed after putting a chest drain. Diaphragmatic agenesis did not require
any additional procedure. The cyst was excised with closure of bronchocystic opening.
The patient had an uneventful recovery. Conclusions: The association of lung cyst with
diaphragmatic agenesis (presented in the adulthood) is rare. It has precluded a diaphragmatic
hernia and survived the patient acting as a protective barrier. The significance
of lung cyst in presence of diaphragmatic agenesis lies in the absence of associated
diaphragmatic hernia which has not been documented previously.