Delayed presentation of bilateral diaphragmatic palsy following trauma

Abstract

The diaphragm is the main respiratory muscle, its dysfunction can lead to serious consequences. Diaphragm paralysis can be a result of various causes, most common of being injury to phrenic nerve following thoracic surgeries. Presentation can vary from a totally asymptomatic patient to disabling condition requiring mechanical ventilation. Clinically paradoxical breathing is evident. Spirometry shows drop in lung capacity, with significant decline in supine position, which is typical of diaphragmatic palsy. Treatment depends on the cause. Surgical approach of repair of diaphragm or nonsurgical approach of non-invasive ventilation has been successful. We report a case of 33-year-old male with bilateral diaphragm palsy, managed with non-invasive ventilation.