An Inside Into a Rare Living Liver Donor Hepatectomy Complication: Acute Mechanical Bowel Obstruction Resulting from a Diaphragmatic Hernia

•Diaphragmatic hernia is rare after donor hepatectomy.•It is common after right donor hepatectomy.•Graft repair can be done.•It can be repaired transabdominal or transthoracic. Living donor liver transplantation is encouraged due to the limited availability of cadaveric donors. However, this patient group is at risk for various complications. Diaphragmatic hernia is a rare complication but often requires reoperation. Given its poor characterization, clinicians and radiologists should remain vigilant about this potential issue. At our center, after 1233 donor hepatectomy operations performed between 2004 and 2024, 2 cases (0.16%) of postoperative diaphragmatic hernia were observed. Both patients were operated on under emergency conditions and via a transabdominal approach. We present these 2 cases along with a literature review. Patients should be treated even if they are asymptomatic. As far as we know, 38 cases have been reported in the literature, with most treated surgically. Both transabdominal and transthoracic approaches can be used. Primary repair or mesh repair can be performed. The patients in our series are followed up without any problems after the operation. If left untreated, it can lead to complications that may result in death. In our article, we aim to present this rare complication through 2 case reports, accompanied by a review of the relevant literature. [Display omitted]