1- Introduction
Congenital diaphragmatic eventration (DE) is an uncommon disorder that may result from abnormal development where diaphragmatic muscle is replaced with fibroelastic tissue or damage to the phrenic nerve. Presentation is variable from asymptomatic incidental findings on X-ray to respiratory distress. Bilateral DE is a rarer diagnosis with a guarded prognosis. We present a preterm infant born at 32 weeks with bilateral DE who presented with persistent respiratory insufficiency, resulting in a management dilemma.