Diaphragmatic eventration mimicking congenital diaphragmatic hernia: The value of chest radiograph and barium meal in diagnosis

Saleh, Mohammed Kabir; Suwaid, Mohammad Abba; Idris, SK; Tabari, AM; Isyaku, Kabiru

doi:10.4103/0331-8540.102114

Cited by 4 publications

(5 citation statements)

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“…The degree of respiratory distress varies and correlates with the size of the defect. Patients are asymptomatic with small localized defects [4], whereas large defects in neonates can cause respiratory distress [5]. Our case is uncommon, as our patient had right sided eventration, as almost invariably complete diaphragmatic eventration occurs on the left side [1].…”

Section: Discussionmentioning

confidence: 84%

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Diaphragmatic Eventration Misdiagnosed as Diaphragmatic Hernia in a Preterm Infant with Respiratory Distress: A Case Report and Review of Diagnosis and Management

Bishara¹,

Burjonrappa²,

Pirzada³

et al. 2015

Open J Pediatr Child Health

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Introduction:Eventration of diaphragm is a congenital anomaly that results from a failure of muscular development of part or all of the hemidiaphragm. Clinically, eventration of diaphragm refers to an abnormal elevation of an intact diaphragm. In some cases, it may be difficult to distinguish it from congenital diaphragmatic hernia (CDH). Case Presentation:A three-week-old male, born prematurely at 30 weeks GA, who was weaned off respiratory support on the first DOL, developed respiratory distress. A chest X-ray obtained at that time when compared with the one from DOL#1 showed a new right lower lobe (RLL) opacity, suggestive of lobar atelectasis. Chest MRI revealed the "atelectatic" RLL to be the liver, raising the suspicion for CDH. Thoracoscopic evaluation revealed instead a diaphragmatic eventration, for which a plication procedure was performed.Discussion: Respiratory distress is the most common clinical manifestation of CDH and diaphragmatic eventration. As in the case of CDH, diaphragmatic eventration can be associated with various degrees of pulmonary hypoplasia due to the compression of the developing lung by the abdominal viscera. The degree of pulmonary hypoplasia and respiratory distress vary depending upon the size of the defect. Patients may be asymptomatic with small localized defects, whereas large defects in neonates can cause respiratory distress. Conclusion:Symptoms of diaphragmatic eventration can be misleading, becoming a diagnostic dilemma despite a proper evaluation. Eventration must be considered in the differential diagnosis of a newborn with respiratory symptoms and a new CXR image suggestive of lower lobe infiltrate.

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Section: Discussionmentioning

confidence: 84%

“…In the case of diaphragmatic eventration, the thinned, weakened musculature is inadequate to restrain the abdominal viscera, the diaphragm rises, and is upwardly displaced together with the abdominal organs during inhalation [4]. In some cases, it may be difficult to distinguish it from CDH.…”

Section: Discussionmentioning

confidence: 99%

Diaphragmatic Eventration Misdiagnosed as Diaphragmatic Hernia in a Preterm Infant with Respiratory Distress: A Case Report and Review of Diagnosis and Management

Bishara¹,

Burjonrappa²,

Pirzada³

et al. 2015

Open J Pediatr Child Health

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“…Diaphragmatic eventration accounts for about 5% of all diaphragmatic anomalies (Saleh et al, 2012). Complete eventrations tend to be more frequent in males and left sided, whereas partial forms are more often described on the right side (Christensen, 1959).…”

Section: Discussionmentioning

confidence: 99%

Parvovirus B19 Intrauterine Infection and Eventration of the Diaphragm

et al. 2022

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Parvovirus B19 infection in pregnancy may have a poor outcome for the fetus. Ocular anomalies, brain damage with hydrocephalus and central nervous system (CNS) scarring, cleft lip and hypospadias, as well myocarditis and congenital heart disease have been reported. We present a case of a preterm female neonate born with ascites, hydrothorax and congenital diaphragmatic eventration (CDE), with a prenatal diagnosis of congenital diaphragmatic hernia (CDH). The neonate was born prematurely at 32 weeks gestation with caesarean section due to a previous caesarean delivery. She was immediately intubated in the delivery room, transferred in the Neonatal Intensive Care Unit (NICU) and supported with high frequency oscillatory ventilation (HFOV). The diagnosis of CDH was sonographically estimated from the 20th week of gestation and surgical correction was decided. During surgery CDE was diagnosed instead of CDH and despite postoperatively care the neonate developed disseminated intravascular coagulation and finally died in the 40th hour of life. Along with the identification of parvovirus B19 in the pleural fluid by PCR, the biopsy of the diaphragm revealed connective tissue, full of vasculature and absence muscle tissue. Although only cytomegalovirus, rubella, and toxoplasmosis were considered to be associated with CDE, parvovirus B19 might also be related to this congenital diaphragmatic malformation. In CDE, the function of the lungs can be compromised as a consequence of the compression applied by the abdominal organs. The neonatologists should include this condition in their differential diagnosis for a more direct and effective management.

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“…In case of severe lung hypoplasia and PH where PaCO 2 is >50 mmHg at a FiO 2 of one, extracorporeal membrane oxygenation (ECMO) can be instituted to prevent lung injury. [ 6 10 ]…”

Section: Discussionmentioning

confidence: 99%

Anaesthetic management of an infant posted for ventricular septal defect closure with right-sided eventration of diaphragm

et al. 2018

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Eventration of the diaphragm is a rare entity, characterised by abnormal elevation of a dome of diaphragm. In this condition, the diaphragm is composed of fibrous tissue with few or no interspersed muscle fibres. Eventration can be congenital or acquired. Congenital eventration results from inadequate development of muscles or absence of phrenic nerve. The common cause of acquired eventration is injury to the phrenic nerve from traumatic birth injury or surgery for heart disease. The perioperative anaesthetic management of diaphragmatic eventration along with ventricular septal defect with severe pulmonary hypertension makes this case both challenging and unique.

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Diaphragmatic eventration mimicking congenital diaphragmatic hernia: The value of chest radiograph and barium meal in diagnosis

Cited by 4 publications

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Diaphragmatic Eventration Misdiagnosed as Diaphragmatic Hernia in a Preterm Infant with Respiratory Distress: A Case Report and Review of Diagnosis and Management

Diaphragmatic Eventration Misdiagnosed as Diaphragmatic Hernia in a Preterm Infant with Respiratory Distress: A Case Report and Review of Diagnosis and Management

Parvovirus B19 Intrauterine Infection and Eventration of the Diaphragm

Anaesthetic management of an infant posted for ventricular septal defect closure with right-sided eventration of diaphragm

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