Left diaphragmatic eventration associated with dextrocardia

Introduction. Congenital diaphragmatic eventration is rare. Its association with dextrocardia is exceptional; only two cases have been previously described, and none of them had associated heart malformation. Case report. A thirty-month-old child presented with recurrent episodes of mild bronchiolitis. A chest X-ray showed elevation of the left hemidiaphragm to the 6th intercostal space and right shift of the mediastinum. A toracoscopic repair of the diaphragmatic defect was performed. Postoperative imaging revealed descent of the diaphragm, but with persistence of the cardiac silhouette to the right. Echocardiogram confirmed dextrocardia without anatomical malformacions. Comments. The association of diaphragmatic eventration with dextrocardia must be considered. Although the most widely accepted treatment is the repair through a thoracotomy, the thoracoscopic approach should also be considered. The later can result in excellent outcome, with less morbidity and shorter recovery time.