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      Heart on the left, diaphragm on the right: A case of congenital diaphragmatic eventration

      case-report

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          Abstract

          Congenital Diaphragmatic Eventration (DE) requires a prompt diagnosis to avert the potentially life‐threatening complications. Herein, a 5‐month‐old male presented with recurrent respiratory infections due to a right‐sided diaphragmatic eventration. Misdiagnosed from previous medical visits, timely surgical intervention by thoracoscopic plication of the diaphragm was crucial for our patient's survival.

          Abstract

          Diaphragmatic eventration (DE) is a life‐threatening abnormality that leads to one or both hemi‐diaphragms being elevated in the thoracic cavity. Congenital DE can fatally hinder lung formation. DE can be easily misdiagnosed, thus recognizing the presentation, and performing accurate interventions can allow for suitable management and favorable outcomes.

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          Most cited references35

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          Long term results of diaphragmatic plication for unilateral diaphragm paralysis.

          To examine whether diaphragmatic plication is an effective and lasting treatment option for non-malignant diaphragmatic paralysis. Nineteen patients who had undergone diaphragm plication (1983-1990) were recalled for interview, pulmonary function testing and chest X-ray. There were 13 men and six women aged 24-73 (mean 55). Diaphragm paralysis was idiopathic (n=9), postsurgical (n=3), related to cervical spondylosis (n=4) and neck injury (n=2). Patients presented with breathlessness (18/19) or orthopnoea (1/19). Symptoms had lasted 3-60 months (mean 24 months). All patients had a raised hemidiaphragm on chest X-ray with paradoxical movement on ultrasound. Mean preoperative FVC was 71% predicted (range 38-93, SD 12.9) and mean FEV(1) was 67% predicted (range 33-90, SD 10.8). Supine lung volumes were 81% (mean) of sitting values. There were six right plications and 13 left. There were no postoperative deaths. One patient required re-plication. Follow-up (18/19 of original operated patients) ranged from 7-14 years (mean 10 years). Three patients had died of unrelated causes and one patient failed to attend long term follow-up, leaving 15 patients of the original 19 operated on. Positional change in lung volumes was not affected by surgery at early (6 week) or late (>5 year) follow-up. FVC, FEV(1), FRC and TLC improved by 10.1*, 11.8*, 16.9* and 9.2*%, respectively, at early follow-up and 11.8*, 15.4*, 26 and 13.3*% at late follow-up (*P<0.005 signed rank). Dyspnoea scores at long term follow-up improved 1 point (n=5), 2 points (n=5) and 3 points (n=2), remained unchanged (n=1) or dropped 1 point (n=2). Of the 15 patients followed up all but one who had been employed returned to work. 14/15 patients expressed satisfaction with their surgery. Diaphragm plication is an effective procedure with lasting results.
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            Congenital diaphragmatic eventration in children: 12years' experience with 177 cases in a single institution

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              New technique of diaphragmatic plication by means of uniportal video-assisted thoracoscopic surgery

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                Author and article information

                Contributors
                asmita.n55@gmail.com
                Journal
                Clin Case Rep
                Clin Case Rep
                10.1002/(ISSN)2050-0904
                CCR3
                Clinical Case Reports
                John Wiley and Sons Inc. (Hoboken )
                2050-0904
                22 November 2021
                November 2021
                : 9
                : 11 ( doiID: 10.1002/ccr3.v9.11 )
                : e05068
                Affiliations
                [ 1 ] University of Health Science Lahore Pakistan
                [ 2 ] Larkin Community Hospital South Miami Florida USA
                [ 3 ] Manipal Hospital Bangalore Karnataka India
                [ 4 ] Jinnah Medical and Dental College Karachi Pakistan
                [ 5 ] Kathmandu Medical College Teaching Hospital Kathmandu Nepal
                Author notes
                [*] [* ] Correspondence

                Asmita Neupane, Kathmandu Medical College Teaching Hospital, Sinamangal, Kathmandu, Nepal.

                Email: asmita.n55@ 123456gmail.com

                Author information
                https://orcid.org/0000-0001-6390-9658
                https://orcid.org/0000-0002-2021-1660
                https://orcid.org/0000-0002-9724-759X
                Article
                CCR35068
                10.1002/ccr3.5068
                8607868
                26892a15-1df5-4d7d-9977-968e957d5c48
                © 2021 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 25 September 2021
                : 12 August 2021
                : 26 October 2021
                Page count
                Figures: 2, Tables: 2, Pages: 0, Words: 4647
                Categories
                Case Report
                Case Report
                Custom metadata
                2.0
                November 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.9 mode:remove_FC converted:22.11.2021

                congenital abnormalities,diaphragmatic eventration,malformation,pediatric infection

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