Abstract
A 65-year-old male was admitted to our clinic because of epigastric pain. The patient had no relevant medical history or past episode of trauma. Ultrasonography demonstrated cholecystolithiasis, and cholecystectomy was performed. During the operation, the right lung became directly exposed above the right lobe of the liver. Examination revealed a total defect of the right diaphragm with a slight rim remaining medially. No herniation of abdominal organs into the thoracic cavity was observed. The right lobe of the liver was attached only to the inferior vena cava without any suspensory ligaments, but the left lobe of the liver was fixed normally with both the triangular and coronary ligament. Postoperative course was uneventful without any herniation or respiratory problems. This is the first reported case of congenital diaphragmatic defect in an adult in Japan. Its pathogenesis and treatment was discussed.
