Eventration of the diaphragm due to phrenic nerve injury caused by intercostal drainage

Diaphragmatic Eventration After Chest Tube Placement in a Neonate: Case Report and Review of the Literature

“…This eventration was temporary and resolved spontaneously over 6 to 10 weeks by conservative management. Ayalon et al 6 and Phillip et al 7 have reported one case each of right eventration of the diaphragm in a neonate due to injury of the right phrenic nerve by a chest tube. In these cases, injury to the nerve was irreversible and both children required surgical plication of the right diaphragm.…”

Diaphragmatic paralysis caused by malposition of chest tube placement after pediatric cardiac surgery

“…One possible explanation is that it is usually placed under well-controlled conditions. Thus, it rarely occurs as compared with other somewhat urgent scenarios, such as life-threatening tension pneumothorax or pleural effusion [1][2][3][4][5][6]. The other possibility is that it could be attributed to the surgery itself and thus be overlooked.…”

“…The possible mechanism of chest tube-induced phrenic nerve injury is friction or compression force of the too deeply placed chest tube impinging on the phrenic nerve [3], which has ever been proved by magnetic resonance imaging [4] and surgical exploration [5]. The consequences of this injury may be mild and reversible neurapraxia [6] or more severe axonotmesis [3] or neurotmesis.…”

“…Diaphragmatic paralysis caused by chest tube injury to the phrenic nerve is occasionally reported in patients following its placement for tension pneumothorax or pleural effusion [1][2][3][4][5][6]. The malposition of too deeply placed chest tube with resultant phrenic nerve injury was presumably the underlying cause [1][2][3][4][5][6].…”

“…The malposition of too deeply placed chest tube with resultant phrenic nerve injury was presumably the underlying cause [1][2][3][4][5][6]. However, this kind of complication is rarely reported in patients following its placement for postoperative drainage after pediatric cardiac surgery.…”