Eventration of diaphragm of unknown cause: A case report

• Published in: International journal of surgery open 2023-08, Vol.57, p.100653, Article 100653
• Main Authors: Dahal, Amartya, Singh, Yadvinder, Ansari, Ajmat, Karmacharya, Robin Man, Vaidya, Satish, Bhatt, Swechha
• Format: Article
• Language: English
• Subjects: Case report; Cough; Diaphragmatic eventration; Plication; Thoracotomy
• ISSN: 2405-8572; 2405-8572
• DOI: 10.1016/j.ijso.2023.100653

Diaphragmatic eventration is a rare disorder with partial or complete thinning of diaphragmatic musculature. The fibroelastic hemidiaphragm, which is pliable, moves paradoxically upward during inspiration resulting in restrictive pulmonary function. It occurs as a result of congenital defect in the diaphragm or secondarily due to phrenic nerve injury. Most patients remain asymptomatic for a long duration—the disease is therefore underdiagnosed. However, in cases of clinical suspicion, chest radiography should be performed, which can be further confirmed by chest computed tomography (CT). We present a case of a 67-year-old male with a right sided diaphragmatic eventration presenting as severe coughing for two months. Surgical plication of right hemidiaphragm was done in multilayer with percutaneous dynamic stabilization (PDS) yielding good outcome. The decision on performing a surgical repair of the defect depends upon the extent of the complications. Symptomatic patients with compromised respiratory, cardiovascular or gastrointestinal function usually require the plication of the diaphragm. Despite the rarity of the disease, clinicians must always evaluate the patient for diaphragmatic eventration to ensure early repair of the defect. •Right sided eventration of diaphragm is unusual.•Most cases remain asymptomatic for a long duration, however, symptomatic cases might require prompt surgical repair.•Diaphragmatic plication yields a good clinical outcome in symptomatic cases.