Many complications have been reported such as bile leakage, ascites and pleural effusion [5]. In our knowledge, a right diaphragmatic hernia after laparoscopic fenestration of a liver benign cyst had never been reported in the literature review. It’s the originality of our case. The diaphragmatic hernia is a herniation of abdominal structures within the thoracic cavity. It can be either congenital or acquired. Diaphragmatic acquired defects

Z-VAD-FMK order are most commonly traumatic in origin, followed by iatrogenic lesions and spontaneous defects [3]. These are usually on the left side, attributed to the cushioning effect of the liver protecting the right hemidiaphragm [3]. Right-sided traumatic diaphragmatic hernias are more often related to penetrating injuries, but may also occur as a complication of surgery. Iatrogenic right diaphragmatic hernias have been reported after laparoscopic cholecystectomy [6], laparoscopic find more hepatectomy [7],

splenectomy [8], laparoscopic gastric banding [9] splenopancreatectomy [10], gastrectomy [11] and after living donor check details liver transplant [12, 13]. Mostly, this complication has been known to develop after esophagectomy and nephrectomy [14–17] (Table 1). Table 1 The characteristics of the reported cases of iatrogenic diaphragmatic hernia Case Age Gender Time to diagnosis Initial surgical procedure Localisation of defect Surgical procedure RAS p21 protein activator 1 Year 1[6] 53 Women 6 weeks Laparoscopic cholecystectomy Right Thoracotomy 1999 2[7] 31 Women 9 months Laparoscopic hepatectomy Left Thoracotomy 2003 3[8] 35 Women 24 months Laparoscopic gastric banding Left Laparotomy approach 2008 4[9] 60 Man 6 weeks Splenectomy for Hydatid cyst Left Thoracotomy 2010 5 [10] 51 Man 4 years Splenopancreatectomy Left Thoracotomy 2006 6[11] 81 Women 8 months Laparoscopy assisted total Gastrectomy total Left Laparoscopy

2012 7[12] 44 Man 28 months Living donor liver transplant Right Laparotomy approach 2010 8[13] 54 Man 3 years Right donor and Hepatectomy Right Thoracotomy 2006 9[14] 50 Man 6 months Nephrectomy Left Thoracotomy 1995 10[15] 74 Man 5 years Nephrectomy Right Thoracotomy 1996 11[16] 69 Man 3 years Nissens procedure Left Thoracotomy 1996 11[18] 39 Women 35 years Transthoracic oesophagogastrectomy Left Laparotomy 1988 12[19] 47 Women 1 day Nephrectomy Left Thoracotomy 2008 13[24] 60 Man 4 months p Lung resection Left Thoracotomy 2010 14[25] 19 Women 2 years Lower lobectomy Left Laparoscopy 2000 Current study 61 Women 1 year Laparoscopic fenestration right liver benign cyst Right Laparotomy 2012 A late presentation of a iatrogenic hernia diaphragm was reported in 5%–62% of cases in different series, with the longest reported delay of 35 years [18]. Grasping instrument and electrocautery and dissection near of the diaphragm may cause diaphragmatic injuries after surgery.