A case of diaphragmatic eventration with marked improvement of respiratory function after diaphragm plication.
Fujimoto, Keisuke Takamatsu Red Cross Hospital
Kenzaki, Koichiro Takamatsu Red Cross Hospital
Matsuda, Takuro Takamatsu Red Cross Hospital
Kubo, Takako Takamatsu Red Cross Hospital
Sawada, Toru Takamatsu Red Cross Hospital
Norimura, Shoko Takamatsu Red Cross Hospital
Hayashi, Akihito Takamatsu Red Cross Hospital
Nanki, Nobuki Takamatsu Red Cross Hospital
Muguruma, Hiroaki Takamatsu Red Cross Hospital
Miura, Kazumasa Takamatsu Red Cross Hospital
Yamamoto, Akiyoshi Takamatsu Red Cross Hospital
A woman in her seventies visited the hospital two months after experiencing dyspnea on exertion. After chest radiographs and computed tomography of the chest showed elevation of the right diaphragm, she was referred to our department for further examination and management. Respiratory function tests revealed restricted ventilatory impairment with a vital capacity （VC） of 1.28 L and a %VC of 54.0%. Since there was no evidence of organic disease causing diaphragmatic paralysis and a slight movement of the diaphragm, we diagnosed the patient with right diaphragmatic eventration. Since she was symptomatic, we decided to treat her surgically. She was operated under general anesthesia, left lateral recumbency, single lung ventilation, and lateral open chest between the eighth ribs. The relaxed diaphragm was elevated, horizontal mattress sutures were placed. Considering the risk of diaphragm rupture, a 2-mm thick Gore-Tex sheet was fixed to the chest wall and diaphragm in a tent-like manner. The patient was discharged from the hospital on the fourth postoperative day. A chest radiograph postoperatively showed good diaphragmatic movement. Respiratory function tests also showed marked improvement, with a VC of 2.00 L and %VC of 86.3%. The patient’s subjective symptoms have disappeared, and she is currently outpatient observation.
Shikoku Acta Medica
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