Traitement chirurgical des éventrations diaphragmatiques

Abstract

Diaphragmatic eventration is a permanent distention of a part or of the whole diaphragm without rupture. Neonatal and children's eventrations that are from congenital origin differ from adults' palsies that are, most of the time, due to a palsy of the phrenic nerve. The paralyzed diaphragmatic muscle can not contract and becomes a flaccid membrane, resulting in a paradoxical breathing. In left eventration, stomach can switch under the diaphragm, creating emptying disorders, disphagia or volvulus. Surgery is indicating only if symptoms are present. Two types of interventions may be proposed: gastropexy with abdominal wall, and phrenoplicatures. Phrenoplicature with thoracotomy is the most frequent intervention except for gastric volvulus.