title: Unilateral diaphragmatic agenesis precluding laparoscopic cholecystectomy.
abstract: BACKGROUND
  Complete absence of a hemidiaphragm or diaphragmatic agenesis in adulthood is rare with only one previous report in the literature. Its significance in relation to performing laparoscopic procedures has not been documented previously.
  
  
  METHODS
  We report a case of previously undiagnosed diaphragmatic agenesis in adulthood precluding laparoscopic cholecystectomy and comprehensively review the literature for papers relevant to diaphragmatic agenesis in adulthood.
  
  
  RESULTS
  Diaphragmatic agenesis in adulthood may complicate and preclude laparoscopic cholecystectomy. The principles of investigation and management of diaphragmatic agenesis complicating laparoscopic surgery are discussed.
  
  
  CONCLUSIONS
  In adults with diaphragmatic agenesis and intrathoracic abdominal viscera precluding laparoscopic cholecystectomy, conservative management is recommended.
authors.affiliation: Department of Surgery, Mercy Hospital and University College, Cork, Ireland. wakai@indigo.ie
authors.forename: A
authors.initials: A
authors.lastname: Wakai
authors.forename: D C
authors.initials: DC
authors.lastname: Winter
authors.forename: G C
authors.initials: GC
authors.lastname: O'Sullivan
mesh_terms: D000328:Adult; D002760:Cholangiopancreatography, Endoscopic Retrograde; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D000013:Congenital Abnormalities / Q000175:diagnosis*; D003964:Diaphragm / Q000002:abnormalities*; D005500:Follow-Up Studies; D042882:Gallstones / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D016896:Treatment Outcome