ABSTRACT

Eventration of the diaphragm is a rare disease in children, defined as an abnormal elevation, either partially or totally, of the diaphragm without a solution of continuity associated with the displacement of the abdominal organs into the chest. Some reports refer an incidence of 1 to 3/1,000 newborns. It occurs more frequently in males, and represents 5% of all diaphragmatic abnormalities. They are classified according to their origin in congenital and acquired each having particular characteristics. It can occur in isolation or associated with other birth defects: pulmonary hypoplasia, congenital heart disease, pectus excavatum, cleft palate, hypospadias, cryptorchidism and congenital torticollis. The diagnosis is made with a chest film and a side where an elevated right hemidiaphragm is displayed at least two intercostal spaces above the left, or left intercostal space high above the law. The treatment of ED differs depending on its origin and clinical manifestations being in some cases required surgical management so a case report and review of the literature is presented.

KEYWORDS

Eventration of the diaphragm, congenital eventration of the diaphragm, diaphragmatic plication, posterolateral thoracotomy.

REFERENCES

1. Majluf R. Enfermedades del diafragma. En: Macri C, Teper A, eds. Enfermedades respiratorias pediátricas. Buenos Aires: McGraw Hill-Interamericana; 2003. p. 751-753.

2. Willcox PG, Pardy RL. Diaphragmatic weackness and paralysis. Lung 1989;167:323-341.

3. Thomas TV. Congenital eventration of the diaphragm. Ann Thorac Surg 1970;10(2):180-192.

4. Jurcak-Zaleski S, Comstock CH, Kirk JS. Eventration of the diaphragm. Prenatal diagnosis. J Ultrasound Med 1990;9(6):351-354.

5. Contreras EI, Escobar HR, Necochea KMC, Castro MS, Sánchez DI. Tres casos de parálisis diafragmática: Utilidad del estudio electromiográfico. Rev Chil Pediatr 2004;75(1):48-54. Disponible en: http://dx.doi.org/10.4067/S0370-41062004000100007

6. Deslauriers J. Eventration of the diaphragm. Chest Surg Clin N Am 1998;8(2):315-530.

7. Schumpelick V, Steinau G, Schlüper I, Prescher A. Surgical embryology and anatomy of the diaphragm with surgical applications. Surg Clin North Am 2000;80(1):213-239, xi.

8. Thomas TV. Nonparalytic eventration of the diaphragm. J Thorac Cardiovasc Surg 1968;55(4):586-593.


9. Kulkarni ML, Sneharoopa B, Vani HN, Nawaz S, Kannan B, Kulkarni PM. Eventration of the diaphragm and associations. Indian J Pediatr 2007;74(2):202-205.

10. Garrido P, Acastello E. Eventración diafragmática en la edad pediátrica. Rev Med Clin Condes 2009;20(6):776-781.

11. Akay TH, Ozkan S, Gultekin B, et al. Diaphragmatic paralysis after cardiac surgery in children: incidence, prognosis and surgical management. Pediatr Surg Int 2006;22(4):341-346.

12. Joho-Arreola AL, Bauersfeld U, Stauffer UG, Baenziger O, Bernet V. Incidente and treatment of diaphagmatic alter cardiac surgery in children. Eur J Cardiothorac Surg 2005;27(1):53-57.


13. Smith CD, Sade RM, Crawford FA, Othersen HB. Diaphragmatic paralysis and eventration in infants. J Thorac Cardiovasc Surg 1986;91(4):490-497.

14. Kapoor V, Wright IM. Congenital myotonic dystrophy with cardiac conduction defect and eventration of the diaphragm. Pediatr Int 2010;52(1):e6-e8. doi: 10.1111/j.1442-200X.2009.02998.x.

15. Wu S, Zang N, Zhu J, Pan Z, Wu C. Congenital diaphragmatic eventration in children: 12 years’ experience with 177 cases in a single institution. J Pediatr Surg 2015;50(7):1088-1092. doi: 10.1016/j.jpedsurg.2014.09.055.

16. Sodhi KS, Narsimhan KL, Bhattacharya A, Khandelwal N. Bilateral congenital diaphragmatic eventration: an unusual cause of respiratory distress in an infant. Afr J Paediatr Surg 2011;8(2):259-260. doi: 10.4103/0189-6725.86082.

17. Gómez-Ruiz A, Medina-Vega FA, Tejeda-Tapia HD. Eventración diafragmática bilateral: informe de un caso y revisión de la literatura. Acta Pediatr Mex 2013;34(3):161-165.

18. Zoffer S, Stolar C. Eventration of the diaphragm. In: Mattei P, editor. Surgical directives: pediatric surgery. Philadelphia: Lippincott, Williams and Wilkins; 2003. p. 527-528.

19. Tracy T, Luks F. Diaphragmatic hernias and eventration. In: Ziegler, editor. Operative pediatric surgery. Philadelphia: McGraw Hill; 2003. p. 495-499.

20. Velázquez PS, Araluce BJ, Velázquez RG, Araluce CM, Trinchet SRM, Figueredo BRJ. Eventración diafragmática en el recién nacido. CCM 2015;19(3):548-555.

21. Sarihan H, Cay A, Akyazici R, Abes M, Imamoglu M. Congenital diaphragmatic eventration: treatment and postoperative evaluation. J Cardiovasc Surg (Torino) 1996;37(2):173-176.