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At least 19 recordsLinked to original sources
PubMed1992

Surgical treatment of diaphragmatic eventration in adults.

Surgical intervention of diaphragmatic eventration is urgent and life-saving in infants but is rarely in adults. In the past 22 years, Seven adults with diaphragmatic eventration were encountered at the Division of thoracic surgery, Dept. of surgery, VGH, Taipei. The age on diagnosis ranged from 32 to 65 years with mean of 44 years old. Male and left diaphragm were more frequently affected (6 men, 1 woman; 6 left, 1 right). All of them received operation of plication. In spite of good immediate postoperative return of the diaphragms to normal position with clinical improvement found in all patients, 5 dyspneic patients were found to have gradual diaphragmatic rise or relapse of respiratory symptoms after repair. Diaphragmatic eventration could cause compression of lung by abdominal organs and reinforcement of diaphragm through plication might increase the diaphragm strength and diminish the clinical symptoms. Yet according to our series, we recommend surgical intervention is only for existence of distress stemmed from it and unresponsive to medical therapy.

Adult↗
PubMed1979

[Congenital diaphragmatic eventration].

The nomenclature of congenital defects of the diaphragm is not unequivocal. Congenital eventration means the incomplete ingrowth of muscle fibers between the pleural and peritoneal sheet of the diaphragm during the embryonal period. The differential diagnosis of eventration and hernia may be very difficult. The adequate surgical treatment differs. As concomitant congenital defects of the ipsilateral lung often occur, congenital eventration should be operated by transthoracic approach. The prognosis of symptomatic eventration is poor in newborns and good in adults. This is illustrated by two own cases. The one deals with a newborn who had a large congenital eventration of the left diaphragm; the other has been reported detailed elsewhere.

Child↗
PubMed1977

Diaphragmatic eventration in infancy and childhood.

Eventration of the diaphragm, although a relatively rare clinical entity, should be considered in all patients with respiratory distress during the neonatal period, particularly in babies born after difficult delivery by breech presentation or forceps extraction. The diagnosis can be made in the majority of spontaneously breathing patients by chest roentgenography or by fluoroscopy. The treatment initially should be supportive, including assisted ventilation if needed. If the infant cannot be weaned off the respirator after a week to ten days of respiratory support, surgical correction of the elevated diaphragm should be carried out. The results of surgical treatment in these desperately sick infants is usually most gratifying.

Child↗
PubMed1979

[Bilateral congenital eventration of the diaphragm with lobar giant emphysema (author's transl)].

The authors relate the difficulties in management of bilateral congenital diaphragmatic eventration in a new-born. After the surgical correction of the left diaphragmatic eventration, an opacity at the base of the right hemithorax was studied by concomittant pulmonary and hepatic scintigraphy and by pneumoperitoneum. The right diaphragmatic eventration was secondarily treated. The baby was later reoperated twice : on the left side at the age of 7 months for a partial relaps of the left eventration, then at the age of 9 months for a malformative giant lobar emphysema of the right middle lobe, requiring lobectomy.

Diaphragmatic Eventration↗
PubMed1977

Acquired eventration of the diaphragm--results of surgery.

Results of surgical repair of acquired diaphragmatic eventration are reported. The series consists of nine adult patients studied pre- and postoperatively with clinical, radiological and lung function investigations. The repair was performed in all cases by a thoracic approach and plication of the diaphragm. The operative procedure was well tolerated in all cases. On follow-up seven patients were found to be improved and in two transient or no improvement occurred. Subjectively, gastrointestinal symptoms were alleviated most often by the operation. Radiological studies showed that although the immediate postoperative position of the diaphragm was very good in all cases, the diaphragm began to stretch and elevate gradually during the first year. In one case rupture of the repaired diaphragm developed 2 years after plication. Reoperation was performed with success. In one case the anatomical end result was no better than before the repair, in the others it was partially or completely improved. Plate atelectasis was observed no longer after the operation. Preoperative lung function studies showed a slight to moderate restrictive defect in 8 cases and a marked one in one case. 37% of the total lung perfusion was distributed to the affected side. On the average no significant changes could be found between the pre- and postoperative values.

Adult↗
PubMed1975

Radiographic appearances following the Thal procedure.

The Thal procedure for repair of distal esophageal stricture is described briefly and the radiographic appearance is ilustrated. The radiologist should be aware of the procedure to avoid confusing the post-operative appearance with a para-esophageal hiatus hernia or diaphragmatic eventration.

Adult↗
PubMed1976

Congenital anomalies of the diaphragm. Personal experience with thirty-five consecutive cases.

A personal experience of thirty-five consecutive patients with congenital anomalies of the diaphragm is reported. The anomalies included twenty-five Bochdalek hernias, seven diaphragmatic eventrations, and three esophageal hiatal hernias. Except for the patients with esophageal hiatal hernias, virtually all patients presented with respiratory embarrassment, twenty-seven of the thirty-five within 24 hours of birth. An especially high mortality is associated with this early onset of symptoms. The treatment was surgical with a thoracic approach used for right Bochdalek defects and eventrations, and an abdominal approach used for left Bochdalek hernias. The importance of proper preoperative and postoperative management in a well equipped neonatal intensive care unit is emphasized.

Diaphragm↗
PubMedDate not supplied

[Gammagraphic diagnosis of diaphragmatic abnormalities in children].

Hepatic and lung scanning were evaluated as complement methods of congenital defects in the diaphragm, 14 cases were evaluated in which the scan showed alteration on the morphology and function of the liver or lung. On 13 cases correlation was found between the surgical diagnosis and the scan. In 4 cases with diaphragmatic hernia (2 Morgagni and 2 Bochdalek) the scan showed that one portion of the hepatic tissue was localized in the thoracic cavity and in one case of diaphragmatic agenesis in the scan the liver occupied the whole right hemithorax. In 9 cases of diaphragmatic eventration the scan showed alteration of the pulmonary perfussion in large or small areas and generally the hepatic image was displaced towards the thorax. These results showed that the scanning is a trustworthy method and of great help in the diagnosis of congenital diaphragmaic malformations.

Child↗
PubMed1976

Neonatal diaphragmatic dysfunction.

Several unusual diaphragmatic problems in the neonate are presented and a new potential complication of the negative pressure respirator is illustrated. The association of bilateral diaphragmatic eventrations with chromosome anomalies is emphasized. In our experience the appearance of the chest on frontal and lateral views is usually so characteristic that no further evaluation is required. The relationship between several neuromuscular disorders and diaphragmatic dysfunction is discussed. A case of congenital myotonic dystrophy with unilateral eventration is illustrated.

Chromosomes, Human, 13-15↗
PubMed1977

Diaphragmatic paralysis and eventration: newer approaches to diagnosis and operative correction.

Positive contrast peritoneography allows the preoperative demonstration of the exact diaphragmatic contour in suspected eventration or paralysis. Anatomical appearances of bilateral elevation or infracardiac involvement will indicate the need for abdominal rather than transthoracic approach for repair. The use of peritoneography should permit rapid evaluation of newborns with respiratory distress and allow repair before long-standing respirator support has produced pulmonary parenchymal damage.

Diaphragm↗
PubMed1977

Radiographic appearance of the chest after pleural space reduction procedures: construction of a pleural tent and phrenoplasty.

Construction of a pleural tent and phrenoplasty are surgical procedures performed to reduce intrapleural dead space after partial lung resection. Both alter the radiographic appearance of the chest and may cause erroneous diagnosis including pneumothorax, subphrenic disease, subpulmonic effusion, diagphragmatic hernia, or diaphragmatic eventration. Radiologists should be aware of the potentially misleading appearance that these surgical procedures may present.

Air↗
PubMed1992

Pediatric gastric volvulus--experience with 7 cases.

Gastric volvulus, organoaxial or mesenterioaxial, is a rare condition in infancy and childhood. We experienced 7 cases of pediatric gastric volvulus, consisting of 3 cases of secondary gastric volvulus due to left diaphragmatic eventration or paraesophageal hernia and 4 cases of idiopathic gastric volvulus. Of 7 cases, five were organoaxial in type and two were mesenterioaxial. The main symptoms of secondary gastric volvulus were vomiting and respiratory difficulty whereas those of idiopathic gastric volvulus were abdominal distension and weight loss with or without failure to thrive. It may be suspected on plain abdominal radiographs and usually confirmed by upper gastrointestinal series. Upper gastrointestinal series in organaxial volvulus demonstrated characteristic findings such as reversal of the greater and lesser curvatures and two air-fluid levels. In mesenterioaxial volvulus, the stomach was rotated into inverted position with pyloroantral obstruction showing a beak appearance. The three patients with secondary volvulus underwent repair of associated defect with or without gastropexy and the 3 patients with idiopathic volvulus underwent anterior gastropexy or gastrostomy. In those with idiopathic gastric volvulus, there was no obvious cause such as laxity of the perigastric ligaments. The operative results were satisfactory except for the three patients with idiopathic gastric volvulus whose abdomen remained distended regardless of weight gain.

Child↗