Eventration of diaphragm of unknown cause: A case report

Introduction and importance

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).

Case presentation

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.

Clinical discussion

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.

Conclusion

Despite the rarity of the disease, clinicians must always evaluate the patient for diaphragmatic eventration to ensure early repair of the defect.