# A Case Report of a Diaphragmatic Defect Developing Into a Late-Presenting Congenital Diaphragmatic Hernia With Severe Respiratory Failure

## TL;DR

A 62-year-old patient developed a rare congenital diaphragmatic hernia causing severe respiratory failure after surgery.

## Contribution

This case report highlights the rare occurrence of late-presenting congenital diaphragmatic hernia in an elderly patient.

## Key findings

- The patient was asymptomatic until 62 and developed a hernia after surgery for ear cancer.
- The case emphasizes the importance of considering CDH in unexplained diaphragmatic elevations during surgery.
- Surgical treatment was required following the diagnosis of the hernia.

## Abstract

Diaphragmatic hernia is a congenital malformation, often discovered in the neonatal period, and its occurrence in adults is very rare. This patient, who was completely asymptomatic until the age of 62, had developed an intestinal obstruction and went into respiratory failure after surgery for an external auditory canal carcinoma. He was subsequently diagnosed with a late-presenting congenital diaphragmatic hernia (CDH), thus requiring surgical treatment. Anesthesiologists and critical care physicians should keep in mind the possibility of CDH as well as diaphragmatic relaxation when an unexplained elevation of the diaphragm is observed perioperatively.