Background: Bilaterality of congenital diaphragmatic pathologies is well do
cumented in the English literature. Nevertheless, ipsilateral simultaneous
congenital diaphragmatic pathologies, though rare, are worth revisiting to
shed more light into their embryology and management.
Methods: A review of the literature for reported cases of multiple ipsilate
ral congenital diaphragmatic pathologies was performed. Their findings, man
agement and outcomes were classified and reviewed, in addition to reporting
and comparison with a new case from our medical center.
Results: Two patients were adult females with multiple defects in the Fight
central tendon of the diaphragm. The remaining four were all pediatric cas
es. Two had double congenital hernial defects on the same side and two had
the defect associated with ipsilateral diaphragmatic eventration. Our case
is the third one with diaphragmatic eventration, but the first being associ
ated with a posterolateral defect on the same side. Its presentation with a
cute rectal bleeding proved difficult to diagnose.
Conclusion: There are various postulated theories concerning the pathogenes
is of ipsilateral pathologies during embryologic development of the diaphra
gm. Management of asymptomatic congenital eventrations remains debatable. H
owever, when symptoms become apparent, ipsilateral defects though rare, sho
uld be considered and prompt surgical management through a thoracotomy or l
aparotomy approach is recommended.