Thoracoscopic Plication for Neonatal Diaphragmatic Eventration With Intrathoracic Ectopic Kidney: A Rare Case Report

Abstract

Coexistence of congenital diaphragmatic eventration (CDE) and an intrathoracic ectopic kidney (ITEK) is extremely rare and may lead to substantial respiratory distress in neonates. This study reports the case of a small-for-gestational-age male neonate presenting with respiratory distress and requiring nasal continuous positive airway pressure. Computed tomography revealed right-sided CDE accompanied by an ITEK. At 44 days old, the infant underwent thoracoscopic diaphragmatic plication. CO₂ insufflation during surgery led to spontaneous reduction of the ectopic kidney into the abdominal cavity, eliminating the need for direct manipulation. The postoperative course was uneventful, and at 14 months, the child remains healthy with no signs of recurrence. This case demonstrates that thoracoscopic plication is a safe and effective option for managing this rare condition, even in low-birth-weight infants. It also suggests that the ectopic position of the kidney is a secondary consequence of diaphragmatic laxity.