• Journal of Chest Surgery
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• v.9 no.2
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• pp.328-335
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• 1976

This case report included 4 cases of traumatic diaphragmatic hernias, 3 cases of non-traumatic diaphragmatic hernias, and 3 cases of eventration of the diaphragm. Among the traumatic hernias, one case was in immediate phase of traumatic diaphragmatic rupture by traffic accident, 2 cases were in intermediate phase with chronic respiratory or vague gastrointestinal symptoms after traffic accident, and the other was developed after an operation, decortication for a chronic empyema with severe pleural calcifications, damaging the diaphragm. Three cases of nontraumatic diaphragmatic hernia were presented, including 2 cases of probable Bochadlek's hernia (Parents refused operation) and a case of Morgagni's hernia with severe gastrointestinal symptoms. And three cases of eventration of the diaphragm with symptoms were also reported. Results of all treated cases were excellent.

• Journal of Chest Surgery
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• v.11 no.1
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• pp.92-96
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• 1978

Congenital diaphragmatic eventration is a rare disease and generally accepted as an abnormally high position of part or all of the diaphragm, usually associated with a marked decrease in muscle fibers and a membranous appearance of the abnormal area. There were 4 cases of the congenital diaphragmatic eventration at the Dept. of Thoracic Surgery, Seoul National University Hospital, from 1957 to 1977. They were two boys and two girls and ranging from 1 day to 3 years of age. They were all repaired by surgical operation and one was expired postoperatively, another one was dead one year later due to complication. The ratio between right and left was 1:3 and their symptoms were cyanosis, dyspnea and frequent respiratory disease. In physical examination there was noted decreased breathing sound on the affected lung field and bowel sound was audible in some cases. Diagnosis was done by Chest X-ray and plication of the affected diaphragm was usually done in operation. There were noted atelectasis and cystic change of the affected side lung. And the liver, colon, spleen and small intestine were found in the dome of the eventrated diaphragm.

• Journal of Chest Surgery
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• v.34 no.12
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• pp.972-975
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• 2001

A case of congenital diaphragmatic eventration on the right and central tendinous portion with accessory hepatic lobe causing direct compression of the right heart is presented. We have performed the video assisted thoracoscopic plication of the right hemidiaphragm and eliminated the mass effect of the accessory hepatic lobe.

• Journal of Chest Surgery
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• v.48 no.5
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• pp.307-310
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• 2015

Background: To evaluate our experience of early surgical plication for diaphragmatic eventration (DE) in infancy and childhood. Methods: This study evaluated infants and children with symptomatic DE who underwent plication through an open transthoracic approach in our childhood development department between January 2005 and December 2012. Surgical plication was performed in several rows using polypropylene U-stitches with Teflon pledgets. Results: The study included 12 infants and children (7 boys and 5 girls) with symptomatic DE (9 congenital and 3 acquired). Reported symptoms included respiratory distress (91.7%), wheezing (75%), cough (66.7%), and recurrent pneumonia (50%). Preoperative mechanical ventilatory support was required in 41.7% of the patients. The mean length of hospital stay was $6.3{\pm}2.5days$. The mean follow-up period was $24.3{\pm}14.5months$. Preoperative symptoms were immediately relieved after surgery in 83.3% of patients and persisted in 16.7% of patients one year after surgery. All patients survived to the end of the two-year follow-up and none had recurrence of DE. Conclusion: Early diagnosis and surgical plication of the diaphragm for symptomatic congenital or acquired diaphragmatic eventration offers a good clinical outcome with no recurrence.

• Journal of Chest Surgery
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• v.11 no.4
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• pp.433-440
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• 1978

Congenital diaphragmatic hernia is an important cause of respiratory distress in the newborn. Eventration, with which these conditions are easily confused, may also Produce severe respiratory distress in infancy or be an asymptomatic radiographic finding. Harrington`s classification of diaphragmatic hernias into two categories, traumatic and nontraumatic, is most widely accepted. Nontraumatic hernias are [1] the congenital types, composed of the posterolateral [Bochdalek], those through the esophageal hiatus, the parasternal [/Morgagni], and those through a defect left by partial absense posteriorly, and [2] the acquired types, composed of those through the esophagea/hiatus [sliding and paraesophageal] and those the sites mentioned above under the congenital hernias. During the period from 1970 up to October 1978, 21 cases of diaphragmatic hernia were treated in department of cardiovascular and thoracic surgery. 11 cases of Bochdalek hernias, 1 case of Morgagni hernia, 5 cases of diaphragmatic eventration and 3 cases of hiatal hernia [2 cases of paraesophageal and 1 cases of sliding type], were experienced. 3 cases of 20 died of respiratory insufficiency, 2 cases of mortality were combined with left lung hypoplasia with Bochdalek hernia.

• Journal of Chest Surgery
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• v.28 no.4
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• pp.381-386
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• 1995

In our hospital we have seen 20 cases of congenital diaphragmatic anomalies from June 1984 until December 1993. These were classified into 10 cases of diaphragmatic eventration, 8 cases of Bochdalek hernia, 1 case of Morgagni hernia, and 1 case of esophageal hiatal hernia. Diaphragmatic eventration cases were composed of 8 males and 2 females with ages varing from 3 hour to 42 year. They were discovered by symptoms: 5 cases of respiratory insufficiency; 3 cases of frequent respiratory infection; and 2 cases by chance; 6 cases involved the left side, 4 cases involved right side. Emergency operations were done to 4 patients. Among the 10 patients, only one operative mortality occurred; 3 hour old female.Bochdalek hernia cases composed 6 females and 2 males, 5 patients were less than 6 hour old. All patients were operated on an emergency status and three of them expired due to the vicious cycle of pulmonary hypertension and pulmonary vasoconstriction, persistent fetal circulation, hypoxia, and metabolic acidosis. Morgagni hernia was seen in one 69 year old female patient, she had no complaint of symptoms and was incidentally detected. Hernia was repaired through right thoracotomy. She was discharged with healthy appearence. Esophageal hiatal hernia was seen in a 10 month old male patient, his symptoms were persistent vomiting and coughing since birth. Sliding type of esophageal hiatal hernia repair was completed through left thoracotomy.

• Advances in pediatric surgery
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• v.10 no.2
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• pp.142-144
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• 2004

A one day old female infant was brought to the emergency room suffering from shortness of breath. An x-ray revealed the gastrointestinal tract in the right thoracic cavity. An emergency operation demonstrated eventration of the diaphragm, and a plication was performed. The baby was discharged without complication and has been followed up in the out patient clinic. Congenital diaphragmatic eventuation requiring emergency operation is rare.

• Journal of Chest Surgery
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• v.32 no.3
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• pp.330-332
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• 1999

A 40-year-old woman underwent plication by video-assisted thoracoscopy for left diaphragmatic eventration. Normalization in the position of the left diaphragm and a marked improvement in the left lung expansion were identified on the chest X-ray. This technique offers the patients many advantages of the minimally invasive operation.

• Journal of Chest Surgery
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• v.21 no.1
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• pp.175-183
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• 1988

Congenital diaphragmatic hernia [CDH] is a surgical emergency in the newborn infant because it causes severe cardiorespiratory distress. Congenital diaphragmatic eventration [CDE] may also produce severe cardiorespiratory distress in the newborn infant. CDH is an anatomically simple defect that can be easily repaired by reduction of the displaced viscera from the pleural cavity and closure of the diaphragmatic defect. But these infants mortality has not been reduced and still remains very high. The barrier to survival is pulmonary parenchymal and vascular hypoplasia as well as the complex syndrome of persistent fetal circulation. Between May, 1985 and Oct, 1987, 4 neonates with CDH and 1 neonate with CDE were seen in respiratory distress within 12 hrs of birth at St. Francisco general hospital. Each had severe acidosis and hypoxia. And was transferred from a local clinic. They were surgically repaired within 24 hrs of birth. Three neonates lived and two died. Two of the three neonates with CDH operated in the first 6 hrs died. The remaining two [one with CDH, the other with CDE] operated between 6hrs and 24 hrs lived. One case of mortality was combined with bilateral pulmonary hypoplasia and contralateral pneumothorax. The other one case of mortality was combined with complex syndrome of persistent fetal circulation after honeymoon period.

• Journal of Chest Surgery
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• v.39 no.9 s.266
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• pp.725-728
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• 2006

A six-month old boy and a thirty-month old girl who suffered from dyspnea were admitted to our hospital. Their primary disease was congenital myopathy, and both of them had a history of recurrent pneumonia. Chest X-ray scan showed unilateral diaphragmatic eventration. To minimize the injury of weakened respiratory muscle in children with myopathy, VATS plication was performed under double lung ventilation. Each of the two patients were discharged on the 17th and 24th postoperative day. We report two cases of successful VATS plication in children with diaphragmatic eventration associated with congenital myopathy.