Although the patient had follow-up up until 2 years, long term benefits in these patients are yet still to be determined. Pulmonary function tests PFTs are important for a dyspneic patient with an elevated hemidiaphragm for highlighting the forced vital capacity and forced expiratory volume in 1 second, showing a restrictive pattern. Each surgical team establishes its own criteria for surgery. Diaphragmatic plication, Diaphragmatic exenteration, Atelectasis. The renal vasculature and the ureter entered and exited the thorax through the foramen of Bochdalek.

Clifton and Wulkan [ 27 ] reports the use of PTFE in patients with hernias and eventrations with an excellent description of the operative technique in neonates. Foci of pulmonary condensation, atelectasis, or mediastinal deviations can be observed. The persistence of the nephrogenic cord or effects of the liver and adrenal gland development are also described in the pathogenesis [ 7 — 9 , 16 , 29 — 33 ]. The scan showed bowel loops in the left hemithorax with no masses noted in the chest Fig. Subscribe to Table of Contents Alerts. Ultrasonography has also been used to visualize the PM of the diaphragm. There is indication for surgical intervention only in the presence of symptoms [2] , [5].

Int J Surg Case Rep. Axial view of the Chest CT-scan IV and oral contrast showing gastric and bowel contents in the left hemithorax.

Presented case was a year-old deceased man with a sequel of poliomyelitis who was reportedly found death at home.

Congenital unilateral diaphragmatic eventration in an adult: A rare case presentation

However, as a consequence of systematic ultrasonographic screenings in pregnancy, precision and diagnostic accuracy, and the use of Doppler, we have diagnostic reports of the condition in the prenatal stage [ 34 ], and these have been studied by magnetic resonance imaging as well.

Diaphragmatic eventration associated with thoracic renal ectopia is a very rare entity, considering the age, sex, eventrattion right location of the condition.

It is important to differentiate diaphragmatic hernia and eventration to be able to plan surgical management pre-operatively. Deeper sole arch angle, and flexed toes, more prominent flexion of the thumb, atrophic and relatively thinner extremities below the knees were observed. Diaphragmatic eventration is a rarely seen asymptomatic pathology which is generally diagnosed incidentally Bowel loops occupying the right hemithorax.


On physical examination there were decreased breath sounds in the left thorax with note diaphraymatic gurgling bowel sounds. There are diaphragmatkc that diaphragmatic eventration diagnosed even as late 70 years old, highlighting the dogma that this is an asymptomatic disorder does not need all the time surgical therapy.

Chest Xray AP view showing shift of the cardiac shadow to the right with note of bowel loops in the left thorax. The prosthetic mesh is used in cases of extreme amyotrophy [ 4 ] by placing it on the surface of the muscle, fixing it in the peripheral diaphragmatic inserts, and preventing recurrence at the ends of the plication; some authors are reluctant to use it due to the possibility of infection and increased cost of surgery, although these criteria are relative, if properly managed.

CASE REPORT As reported by his family, stuudy old male patient who dizphragmatic found dead at home, had suffered stufy poliomyelitis when he was a child, and also treated for respiratory tract diseases.

Many genes are related to renal anomalies, but it is not known if there is a genetic anomaly that relates the renal ectopia and diaphragmatic defect; however, certain genes Osr may be related [ 29 ]. A Ct-scan with thin sections can evaluate the diaphragm and oral contrast swallow can clearly outline upper casse organs that were visualized in plain radiographs [7]. The overall cause of death of the our patient was reported as heart failure. Whether surgery indeed improved lung functions in these vastly asymptomatic patients, these questions could be an active area of research in the long term outcomes of these patients.

Congenital unilateral diaphragmatic eventration in an adult: A rare case presentation

The patient was started on incentive spirometry and deep breathing exercises Fig. On the left side, stomach, spleen, and small intestines, and on the right side liver were pushed into the thoracic cavity.

case study diaphragmatic eventration

Most adult patients with diaphragmatic eventration remain asymptomatic, and the diagnosis is made incidentally after chest eventgation. Thoracic renal ectopia is rare, with a prevalence of 1 in 10, cases of ectopic kidneys. While the incidence of gastric volvulus in the setting of eventration has yet to be widely determined, the repair of eventration to prevent this complication theoretically will benefit the patient. Incision eventratuon the laminated and elongated hemidiaphragm with the presence of muscle fibers.


Thus, follow-up is important in patients who underwent plication of diaphragmatic eventration to assess recurrences and its long term complications.

In infants, the symptoms are severe due to the poor development of the thoracic cage and weakness of diapgragmatic intercostal muscles that cause paradoxical breathing and require the use of mechanical ventilation [ 313 ]. Physical examination showed bowel sound involving the left hemithorax.

Case Reports in Surgery

Our case is not common, as it refers to an adult woman with a right thoracic kidney and is associated with diaphragmatic eventration type 2. Coronal view of the Chest CT-scan IV and oral contrast showing gastric and bowel contents in the left hemithorax. Resection of the redundant diaphragm and reapproach evntration overlapping edges have been described, similar to the Mayo technique for umbilical hernia.

case study diaphragmatic eventration

Plication by posterolateral thoracotomy is achieved through the sixth, seventh, or eighth intercostal space, using U points, mattress stitch, continuous suture, or stapling [ 3 ]. Diaphragmatic eventration was first identified by Jean Louis Petit inthe term was first used by Beclard inand the first surgical repair was described eventrafion by Morrison [ 2411 ].

The surgical treatment pursues the improvement of ventilation by minimizing dysfunctional diaphragmatic excursion in the process of inspiration [ 3 ]; Yalcinkaya et al.

case study diaphragmatic eventration

The result is decreased respiratory mobility or paradoxical movement, causing poor lung expansion and hypoxia [ 13 ]. We describe the case of a year-old girl with dry cough, chest pain, respiratory distress, and bronchial spasms for 4 years and presumable repeated episodes of bronchial asthma since her childhood.