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Diaphragmatic Eventration

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Pediatric Thoracic Surgery

Abstract

In general, diaphragmatic eventration (DE) is defined as abnormal elevation of all (or a portion of) an attenuated (but otherwise intact) diaphragmatic leaf [1]. The term “eventration” was used first by Becklard in 1829 (through Petit probably described the condition in 1970). Bingham described plication of the diaphragm in 1954 [2, 3]. Based on etiopathogenesis, DE may be classified as “congenital” or “acquired” even though the clinical features and principles of management are similar for both forms.

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References

  1. Yazici M, Karaca I, Arikan A et al (2003) Congenital eventration of the diaphragm in children: 25 years’ experience in three pediatric surgery centers. Eur J Pediatr Surg 13:298–301

    Google Scholar 

  2. Bisgard J (1947) Congenital eventration of the diaphragm. J Thorac Surg 16:484–491

    PubMed  CAS  Google Scholar 

  3. Bingham JAW (1954) Two cases of unilateral paralysis of the diaphragm in the newborn treated surgically. Thorax 9:248–252

    Article  PubMed  CAS  Google Scholar 

  4. Tsugawa C, Kimura K, Nishijima E et al (1997) Diaphragmatic eventration in infants and children: is conservative treatment justified? J Pediatr Surg 32:1643–1644

    Google Scholar 

  5. Groth SS, Andrade RS (2009) Diaphragmatic eventration. Thorac Surg Clin 19:511–519

    Article  PubMed  Google Scholar 

  6. Foad SL, Mehlman CT, Ying J (2008) The epidemiology of neonatal brachial plexus palsy in the United States. J Bone Joint Surg 90:1258–1264

    Article  PubMed  Google Scholar 

  7. Adler JB, Patterson RL Jr (1967) Erb’s palsy. Longterm results of treatment in eighty-eight cases. J Bone Joint Surg 49:1052–1064

    PubMed  CAS  Google Scholar 

  8. Gurewitsch ED, Johnson E, Hamzehzadeh S, Allen RH (2006) Risk factors for brachial plexus injury with and without shoulder dystocia. Am J Obstet Gynecol 194:486–492

    Article  PubMed  Google Scholar 

  9. Nath RK, Kumar N, Avila MB et al (2012) Risk factors at birth for permanent obstetric brachial plexus injury and associated osseous deformities. ISRN Pediatr 2012:307039

    Google Scholar 

  10. Crabbe DCG. Diaphragmatic eventration and phrenic palsy. In: Parikh DH, Crabbe DCG, Auldist AW, Rothenberg SS (eds) Pediatric thoracic surgery. Springer, Berlin, p 501–508

    Google Scholar 

  11. Joho-Arreola AL, Bauersfeld U, Stauffer UG, Baenziger O, Bernet V (2005) Incidence and treatment of diaphragmatic paralysis after cardiac surgery in children. Eur J Cardiothorac Surg 27:53–57

    Article  PubMed  Google Scholar 

  12. Lemmer J, Stiller B, Heise G et al (2006) Postoperative phrenic nerve palsy: early clinical implications and management. Inten Care Med 32:1227–1233

    Google Scholar 

  13. Porth SC (2004) Recognition and management of respiratory dysfunction in children with tetraplegia. J Spinal Cord Med 27:S75–S79

    PubMed  Google Scholar 

  14. Puri P, Nakazawa N (2009) Congenital diaphragmatic hernia. In: Puri P, Höllwarth M (eds) Pediatric surgery: diagnosis and management. Springer, Berlin p 306–313

    Chapter  Google Scholar 

  15. Huttl TP, Wichmann MW, Reichart B et al (2004) Laparoscopic diaphragmatic plication: long-term results of a surgical technique for postoperative phrenic nerve palsy. Surg Endosc 18:547–551

    Google Scholar 

  16. Alexander C (1966) Diaphragm movements and the diagnosis of diaphragm paralysis. Clin Radiol 17:79–83

    Article  PubMed  CAS  Google Scholar 

  17. Cohn DB, Benditt JO, Eveloff SE, McCool FD (1997) Diaphragm thickening during inspiration. J Appl Physiol 83:291–296

    PubMed  CAS  Google Scholar 

  18. Rehan VK, Nakashima JM, Gutman A, Rubin LP, Mc-Cool FD (2000) Effects of the supine and prone position on diaphragm thickness in healthy term infants. Arch Dis Child 83:234–238

    Article  PubMed  CAS  Google Scholar 

  19. De Palo VA, McCool FD (2002) Respiratory muscle evaluation of the patient with neuromuscular disease. Semin Respir Crit Care Med 23:201–209

    Article  Google Scholar 

  20. Puri P (2006) Congenital diaphragmatic hernia and eventration. In: Puri P, Höllwarth M (eds) Pediatric surgery. Springer, Berlin, p 115–138

    Chapter  Google Scholar 

  21. Wayne ER, Campbell JB, Burrington JD, Davis WS (1974) Eventration of the diaphragm. J Pediatr Surg 9:643–651

    Article  PubMed  CAS  Google Scholar 

  22. Shoemaker R, Palmer G, Brown JW, King H (1981) Aggressive treatment of acquired phrenic nerve paralysis in infants and small children. Ann Thorac Surg 32:250–259

    Article  PubMed  CAS  Google Scholar 

  23. Watanabe T, Trusler GA, Williams WG et al (1987) Phrenic nerve paralysis after pediatric cardiac surgery. Retrospective study of 125 cases. J Thorac Cardiovasc Surg 94:383–388

    Google Scholar 

  24. Affatato A, Villagra F, De Leon JP (1988) Phrenic nerve paralysis following pediatric cardiac surgery. Role of diaphragmatic plication. J Cardiovasc Surg (Torino) 29:606–609

    CAS  Google Scholar 

  25. Langer JC, Filler RM, Coles J, Edmonds JF (1988) Plication of the diaphragm for infants and young children with phrenic nerve palsy. J Pediatr Surg 23:749–751

    Article  PubMed  CAS  Google Scholar 

  26. Serraf A, Planche C, Lacour Gayet F et al (1990) Post cardiac surgery phrenic nerve palsy in pediatric patients. Eur J Cardiothorac Surg 4:421–424

    Google Scholar 

  27. Hamilton JR, Tocewicz K, Elliott MJ et al (1990) Paralysed diaphragm after cardiac surgery in children: value of plication. Eur J Cardiothorac Surg 4:487–490 (discussion 490-491)

    Google Scholar 

  28. Kunovsky P, Gibson GA, Pollock JC et al (1993) Management of postoperative paralysis of diaphragm in infants and children. Eur J Cardiothorac Surg 7:342–346

    Google Scholar 

  29. van Onna IE, Metz R, Jekel L (1998) Post cardiac surgery phrenic nerve palsy: value of plication and potential for recovery. Eur J Cardiothorac Surg 14:179–184

    Article  PubMed  Google Scholar 

  30. de Leeuw M, Williams JM, Freedom RM (1999) Impact of diaphragmatic paralysis after cardiothoracic surgery in children. J Thorac Cardiovasc Surg 118:510–517

    Article  PubMed  Google Scholar 

  31. Joho-Arreola AL, Bauersfeld U, Stauffer UG et al (2005) Incidence and treatment of diaphragmatic paralysis after cardiac surgery in children. Eur J Cardiothorac Surg 27:53–57

    Google Scholar 

  32. Akay TH, Ozkan S, Gultekin B et al (2006) Diaphragmatic paralysis after cardiac surgery in children: incidence, prognosis and surgical management. Pediatr Surg Int 22:341–346

    Google Scholar 

  33. Lemmer J, Stiller B, Heise G et al (2006) Postoperative phrenic nerve palsy: early clinical implications and management. Inten Care Med 32:1227–1233

    Google Scholar 

  34. Dagan O, Nimri R, Katz Y et al (2006) Bilateral diaphragm paralysis following cardiac surgery in children: 10-years’ experience. Inten Care Med 32:1222–1226

    Google Scholar 

  35. Becmeur F, Talon I, Schaarschmidt K et al (2005) Thoracoscopic diaphragmatic eventration repair in children: about 10 cases. J Pediatr Surg 40:1712–1715

    Google Scholar 

  36. Rothenberg S (2005) In: Najmaldin A, Rothenberg S, Crabbe D, Beasley S (eds) Operative endoscopy and endoscopic surgery in infants and children. Edward Arnold, London, p 23–29

    Google Scholar 

  37. Moon S-W, Wang W-P, Kim W-Y, Shim S-B, Jin W (2000) Thoracoscopic plication of diaphragm eventration using endostaplers. Ann Thorac Surg 70:299–300

    Article  PubMed  CAS  Google Scholar 

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Correspondence to François Becmeur .

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Molinaro, F., Bulotta, A.L., Cerchia, E., Borruto, F., Messina, M., Becmeur, F. (2013). Diaphragmatic Eventration. In: Lima, M. (eds) Pediatric Thoracic Surgery. Springer, Milano. https://doi.org/10.1007/978-88-470-5202-4_20

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  • DOI: https://doi.org/10.1007/978-88-470-5202-4_20

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-5201-7

  • Online ISBN: 978-88-470-5202-4

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