Acute Respiratory Failure with an Abnormal Chest Radiograph

Clinical and surgical specifications of adult unilateral diaphragmatic eventration according to their aetiology in 28 patients. Importance of using diaphragmatic patch and minimal thoracotomy incision

“…The clinical dyspnoea score reflected the success of the operation better than a pulmonary function test: 3.4 AE 0.9 (range: 3-5) preoperatively versus 1.8 AE 0.7 (range: 1-3) postoperatively ( p = 0.000). The average height of the diaphragm was 7.8 AE 3.1 cm (range: [4][5][6][7][8][9][10][11][12][13][14][15]. The height of the diaphragm was not a determining factor for the severity of dyspnoea (R = 0.06 for preoperative dyspnoea score and R = 0.22 for preoperative FEV 1 ).…”

“…Diaphragmatic eventration (DE) is a rare condition in adults, where the muscle is permanently elevated, but retains its continuity and attachments to the costal margins without defects; the muscular insertions are normal, the apertures are sealed, and there is no interruption in the pleural or peritoneal layers [1][2][3][4]. This condition could be subsequent to a primary or an acquired phrenic nerve palsy, but it often presents as a pure degenerative muscular disease without any evident signs of denervation [5][6][7].…”

Eventration of diaphragm with dextrocardia and type 2 respiratory failure: A rare entity

“…Any acute illness can easily lead to decompensation and progressive respiratory failure. [ 11 ] Although this patient was successfully managed medically, acute presentation have sometimes been successfully managed with surgical plication of the diaphragm. There has a report of successful nonsurgical management of eventration of the hemidiaphragm presenting with acute respiratory distress.…”

“…There has a report of successful nonsurgical management of eventration of the hemidiaphragm presenting with acute respiratory distress. [ 11 ] In adults the diagnosis of diaphragmatic eventration can usually be made on standard posteroanterior and lateral chest films. [ 12 ] A high index of suspicion, past history, previous and present imaging and physical examination of the chest should aid in early and definite diagnosis.…”

“…Even in asymptomatic elderly patients, a close follow-up is recommended. [ 11 ] Aim of reporting this rare entity is to highlight the importance of history taking, good physical examination and imaging in the diagnosis of diaphragmatic eventration.…”