Congenital diaphragmatic hernia in an 81-year-old female presenting as painless jaundice

Introduction and importance: Adult congenital diaphragmatic hernia (CDH) is rare and may present as an incidental finding in an asymptomatic individual. Case presentation: We report the case of an 81-year-old female who presented to the ED with painless jaundice and bilirubin of 19.9 mg/dL. She was diagnosed with biliary obstruction secondary to a right-sided CDH. The patient underwent surgery, which resulted in the correction of her CDH and a downward trend in her bilirubin. Clinical discussion: CDH usually presents in the newborn period with respiratory distress and can have a high mortality rate. Although CDH is most often associated with newborns, it can rarely present in adulthood, manifesting insidiously with a variety of signs and symptoms ranging from a mild cough to biliary occlusion. Conclusion: CDH may be considered in the differential diagnosis when other investigations for respiratory or gastrointestinal complaints have been unrevealing. Highlights