Complete agenesis of the right hemi-diaphragm in an adult: case report and literature review.

Congenital agenesis of the hemi-diaphragm (AHD) in adults is rare and exceedingly so on the right side. Since its first recognition in 1959, no more than 9 cases have been published in the English literature by the year 2016. “Partial diaphragm agenesis” is actually large congenital diaphragmatic hernia (CDH) rather than true AHD. Respiratory compromise is the likely presentation, however, patients may survive for years without symptoms. Despite a straightforward clinical and radiographic diagnosis of AHD, the best method of repair is controversial. Herein, we present a case of complete right-sided AHD in a man of 54 diagnosed on surgical exploration 16 years earlier. Despite trans-thoracic mesh repair, the patient experienced just a modest improvement of his shortness of breath (SOB). Though the liver persisted high in the chest as shown by serial CT scans of the chest, polypropylene mesh was effective in preventing further visceral herniation. Adult patients with right-sided AHD always deserve operative intervention to avoid the potential complications.

Congenital Agenesis of Both Vertebro-Basilar Artery-A Rare Case Report

Vertebral and basilar arteries are the major blood suppliers of the brain. They supply nearly one-third of the brain. Congenital absence of these arteries is a rare condition. Usually, this condition presents with stroke like presentation. This is a case presentation of a 40-year-old lady who was diagnosed as congenital agenesis of vertebra-basilar arteries. This lady was presented with intraventricular hemorrhage. Subsequently the diagnosis was made by cerebral angiogram.

Multidisciplinary approach on lateral incisors agenesis: a case report

Teeth absence in the anterior region of the maxilla can lead to psychosocial impairments, especially in young patients. Thus, the treatment of congenital agenesis of upper lateral incisors should consider prosthetic, restorative, and periodontal approaches to recover the patient's social and aesthetic functions. This article aims to present the case report of a 23-year-old male patient, who visited the Prosthodontic Clinic of the Piracicaba Dental School for the treatment of congenital agenesis of teeth 12 and 22. Implant-supported metal-free ceramic crowns, homemade dental bleaching, and restoration of maxillary canines with composite resin were planned. In addition, to improve gingival thickness around the peri-implant region of tooth 12, a periodontal surgery was performed using the vestibular tunnel access surgical technique (VISTA - Vestibular Incision Subperiosteal Tunnel Access). Thus, a multidisciplinary approach in the treatment of congenital agenesis of the upper lateral incisors has proved to be a reliable alternative to achieve patient's functional and aesthetic demands.

Transjugular approach for zero-fluoroscopy catheter ablation of the right anterolateral accessory pathway

We present a case of successful zero-fluoroscopy catheter ablation (CA) of the right anterolateral accessory (AP) pathway via a transjugular approach in an 18-year-old patient with a congenital agenesis of inferior vena cava (IVC). Three-dimensional (3D) electroanatomic mapping (EAM) system and intracardiac echocardiography (ICE) were used to navigate the catheters in the heart.

Gall bladder agenesis: a surgeon’s dilemma

Congenital agenesis of gall bladder is a rare anomaly which poses a diagnostic dilemma to the surgical fraternity. Ultrasonography, which is the standard investigation of choice in gall bladder diseases often gives a mistaken diagnosis of cholelithiasis in the background of a shrunken gall bladder with hyperechoic shadows suggestive of gall stones. Intra-operatively this poses a surprise to the operating surgeon who fails to locate gall bladder in its normal anatomic position as well as any of the ectopic sites. The controversy in further course of management whether to abandon the procedure and follow-up with a post-operative imaging such as MRCP or to convert the laparoscopic procedure into an open surgery has been a debate for the surgeons. Most of the literature favours the first approach, thereby reducing the morbidity associated with the surgery. In this case report we present a 42-year-old male who presented with symptoms of gall bladder disease to a peripheral surgical centre and how we approached the intra-operative dilemma once gall bladder was not visualized.