Acquired diaphragmatic hernia in pediatrics after living donor liver transplantation Three cases report and review of literature

Rationale: Diaphragmatic hernia (DH) in pediatrics following living donor liver transplantation (LDLT) has been seldom reported in the past. Patient concerns: We report successful diagnosis and treatment of three pediatric cases with DH secondary to LDLT, discuss the possible etiology, and review the relevant literature. Diagnoses: The primary disease was biliary atresia and DH was diagnosed by computed tomography scan or x-ray of chest. Interventions: Laparotomy was performed successfully to repair the DH. Outcomes: The respiratory and digestive function was gradually recovered in 1 to 2 weeks after repair operation. In 2 to 8 months follow-up, patients were asymptomatic without any respiratory or digestive complications. Lessons: DH post-LDLT should be recognized as a possible complication when a left lateral segment graft is used. Careful clinical examination and prompt surgery could minimize complications.