She had symptoms of intermittent dyspnea and occasional epigastric discomfort. Laparoscopy revealed visceral displacement, severe elevation of the diaphragmatic dome, and hepatic displacement; there was no diaphragmatic rupture, defined as eventration. Axial view of the Chest CT-scan IV and oral contrast showing gastric and bowel contents in the left hemithorax. The right colon and part of the transverse colon were adhered to the dome. Table of Contents Alerts.
The difference between eventration and hernia was recorded by Bisgard in , who describes eventration as an abnormally high, or elevated position of one leaf of the diaphragm as a result of paralysis, or atrophy of varying degree of the muscle fibers. The high dome without contraction causes pulmonary collapse causing atelectasis, bronchial or parenchymal infections, or alterations in myocardial excitability due to mediastinum deviation [ 20 ]. Intra-operatively, the diaphragm was noted to be thinned out with the central portion of the left diaphragm attenuated and membranous Fig. The present case was a woman of 17 years of age, with infrequent presentation of complete right defect [ 12 ]. Chest radiography, ultrasonography, intravenous pyelography, computed tomography, and scintigraphy are useful diagnostic tests [ 7 ]; other pathologies may show similar findings; therefore, in many cases, a combination of these tests is necessary to clarify differential chest masses, such as neuroblastoma, ganglioneuroma, neurogenic cyst, meningeal cyst, or Bochdalek hernia [ 9 ].
Patient was started of feeding and was discharged 1 week post-operatively with the lungs fully expanded. Besides, minimally invasive diagnostic laparoscopy has been also recommended as a diagnostic modality 4. External examination revealed a corpse with a height of cm, and weighing 85 kg. Int J Surg Case Rep. Coronal view of the Studt CT-scan IV and oral contrast showing gastric and bowel contents in the left hemithorax.
Congenital unilateral diaphragmatic eventration in an adult: A rare case presentation
Author information Article notes Copyright and License casee Disclaimer. National Center for Biotechnology InformationU. Bowel loops can be seen in the thorax if a radiopaque contrast agent is used [ 10 ].
Diaphragmatic eventration is largely diagnosed in the pediatric age group. Its unbroken continuity differentiates it from diaphragmatic hernia . The difference between eventration and hernia was recorded by Bisgard inwho describes eventration as an abnormally high, or elevated position of one leaf of the diaphragmati as a result of paralysis, or atrophy of varying degree of the muscle fibers.
Surgical repair of congenital diaphragmatic eventration in a septugerian lady. In conclusion, symptomatic diaphragmatic eventration associated with thoracic renal ectopia is a very rare entity, considering the age, sex, and right location of the anomaly. The embryological changes involve abnormal migration of myoblasts from the upper cervical somites to the transverse septum 4 weeks of gestation and pleuroperitoneal membrane 8 to 12 weeks ; microscopy shows diffused fibroelastic changes and lack of fibers.
Contrast coronal section showing both hemithoraces. The thoracic kidney is stdy asymptomatic and discovered by directed search in adult patients with the absence of the kidney on ultrasonography.
Diaphragmatic Eventration: Autopsy Case Report
Anibal Carrasco and Ricardo Castro. The patient stayed in the hospital for 12 days with an adequate evolution of the respiratory symptomatology and the operative wound. Indexed in Web evsntration Science. CASE REPORT As reported by his family, our old male patient who was found evventration at home, had suffered from poliomyelitis when he was a child, and also treated for respiratory tract diseases.
Each surgical team establishes its own criteria for surgery. Acquired diaphragmatic eventration can be caused by phrenic nerve injury resulting in diaphragmatic elevation, and paralysis.
Case Reports in Surgery
The high diaphragmatic level varies and is not a specific criterion to define the condition. The right colon and part of the transverse colon were adhered to the dome.
Source of funding This paper was not funded and it has no study sponsors. No manipulation or treatment is necessary for asymptomatic thoracic kidneys, except when there are other pathologies vesicoureteral reflux or obstruction [ 32 ], such as those found in this patient.
Although, this is a case report, the patient consented to this publication. National Center for Biotechnology InformationU. Open in a separate window. Eventration results in diaphragmatic eventartion and cephalad displacement if the underlying abdominal viscera .
Diaphragmatic Eventration: Autopsy Case Report
Chest Ct-scan with IV and oral contrast was requested to further outline the anatomy. Extreme caution is necessary in patients with morbid obesity or who have neuromuscular disorders [ 3 ].
stury Diaphragmatic crura in the thoracic cavity eventrattion elevated bilaterally, and diaphragmatic eventration was detected. In addition, they should plan an adequate and individualized surgical repair making use, as far as possible, of the minimally invasive procedures that are currently used. In the present case, the laparoscopic approach was used for diagnosing eventration and not diaphragmatic hernia; it also helped in the partial reduction of intestinal loops and release of adhesions of the colon in the roof of the hemidiaphragm.