Multiple ipsilateral congenital diaphragmatic pathologies: Rarities to consider

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.