Diaphragmatic eventration (DE) is the abnormal elevation of a portion or entire hemidiaphragm due to a lack of muscle or nerve function while maintaining its anatomical attachments. The abnormality can be congenital or acquired, thus presenting in both the pediatric and adult populations. The diaphragm is a dome-shaped muscle that plays a strong role in the inspiratory phase of respiration and acts as a barrier between the thoracic and abdominal cavities. The diaphragm is innervated by the phrenic nerve, which originates from the C3, C4, and C5 spinal nerve roots.
The left and right phrenic nerves provide the motor function to each hemidiaphragm, respectively, and impaired development or injury to this nerve can lead to diaphragmatic paralysis and diminished lung expansion. In both congenital and acquired eventration, a portion of the diaphragm is weakened and thin causing reduced function. Depending on the severity, patients may be asymptomatic or present with respiratory symptoms. Diagnosis is confirmed by radiographic imaging, and treatment usually consists of supportive care and, in some cases, surgical plication.
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