Thoracoscopic repair of right-sided diaphragmatic hernia after liver transplantation for hepatoblastoma

Diaphragmatic hernia has been increasingly reported as a rare complication of liver transplantation. Here, we report a case of diagnosis and successful treatment of right-sided diaphragmatic herniation following transplantation of a left-lateral graft in a 14-month old patient treated for hepatoblastoma with neoadjuvant chemotherapy. We suspect a combination of factors contributed to this case of diaphragmatic herniation after liver transplantation, including the patient's suboptimal nutritional status, prior chemotherapy, medial positioning of the graft, and intra-operative photocoagulation. This complication was repaired definitively and with low morbidity utilizing a minimally invasive approach.