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      Case report: repair of eventration of the diaphragm in an octogenarian

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          Abstract

          Eventration of the diaphragm is a cephalad displacement of the diaphragm because of congenital or acquired causes. The diaphragm maintains its anatomical continuity and normal attachments. It may be partial or complete and unilateral or bilateral. Most adult presentations are asymptomatic, but patients may present with respiratory, gastrointestinal, or cardiac symptoms. Surgical repair is indicated in the symptomatic patient with the most common being diaphragmatic plication. We present surgical repair of a symptomatic left diaphragmatic eventration in an octogenarian.

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          Laparoscopic diaphragmatic plication for diaphragmatic paralysis and eventration: an objective evaluation of short-term and midterm results.

          Shawn Groth, Natasha Rueth, Teri Kast … (2010)
          We sought to objectively assess our outcomes after laparoscopic diaphragmatic plication for symptomatic hemidiaphragmatic paralysis or eventration using a respiratory quality-of-life questionnaire and pulmonary function tests.
          Article 0 comments Cited 14 times – based on 0 reviews     Review now
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            Diaphragmatic eventration.

            Shawn Groth, Rafael Andrade (2009)
            Symptomatic diaphragmatic eventration is an uncommon condition and is sometimes impossible to distinguish clinically from paralysis. Patients who are asymptomatic require no treatment; patients who are symptomatic benefit significantly from diaphragm plication. The choice of plication approach is dependent upon the expertise of the surgeon.
            Article 0 comments Cited 11 times – based on 0 reviews     Review now
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              Long term results of diaphragmatic plication for unilateral diaphragm paralysis.

              Afzal Hussain, Simon M Higgs, Mark Jackson … (2002)
              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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                Author and article information

                Contributors
                Ninon Forter-Chee-A-Tow:
                ORCID: https://orcid.org/0009-0003-8215-554X
                Alan Smith:
                ORCID: https://orcid.org/0000-0002-1808-3102
                Journal
                Journal ID (nlm-ta): J Surg Case Rep
                Journal ID (iso-abbrev): J Surg Case Rep
                Journal ID (publisher-id): jscr
                Title: Journal of Surgical Case Reports
                Publisher: Oxford University Press
                ISSN (Electronic): 2042-8812
                Publication date Collection: October 2023
                Publication date (Electronic): 25 October 2023
                Publication date PMC-release: 25 October 2023
                Volume: 2023
                Issue: 10
                Electronic Location Identifier: rjad581
                Affiliations
                Department of Cardiovascular Services, Queen Elizabeth Hospital , Bridgetown 11123, Barbados
                Department of Cardiovascular Services, Queen Elizabeth Hospital , Bridgetown 11123, Barbados
                Author notes
                Corresponding author. Department of Cardiovascular Services, Queen Elizabeth Hospital, Bridgetown 11123, Barbados. E-mail: ninonfcat@ 123456gmail.com
                Author information
                https://orcid.org/0009-0003-8215-554X
                https://orcid.org/0000-0002-1808-3102
                Article
                Publisher ID: rjad581
                DOI: 10.1093/jscr/rjad581
                PMC ID: 10602662
                SO-VID: 6c1e54f8-d1fc-4fe0-bc7c-8888b7c7b077
                Copyright © Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2023.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 5 June 2023
                Date revision received : 21 September 2023
                Page count
                Pages: 3
                Categories
                Subject: Case Report
                Subject: AcademicSubjects/MED00910
                Subject: jscrep/030

                Keywords: diaphragmatic eventration,diaphragmatic plication,thoracoscopic surgery
                Data availability:
                Keywords: diaphragmatic eventration, diaphragmatic plication, thoracoscopic surgery

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