Thoracoscopic plication for diaphragmatic eventration in a 3-month-old infant

Area of Science:

• Pediatric Surgery
• Thoracic Surgery
• Congenital Abnormalities

Background:

• Diaphragmatic eventration is a rare congenital condition where one side of the diaphragm is elevated, potentially causing respiratory distress in infants.
• Infantile respiratory symptoms like shortness of breath, chest retractions, and wheezing can be challenging to diagnose and manage, sometimes initially misdiagnosed as bronchiolitis.

Observation:

• A 3-month-old male infant presented with persistent respiratory symptoms and feeding difficulties unresponsive to standard treatments for bronchiolitis.
• Diagnostic imaging revealed right-sided diaphragmatic eventration as the underlying cause of the infant's respiratory compromise.

Findings:

• The patient underwent successful video-assisted thoracoscopic surgery (VATS) with diaphragmatic plication for the right-sided eventration.
• Postoperative recovery was rapid, with discharge on the second day and complete resolution of respiratory and feeding symptoms within two weeks.
• Radiographic assessment confirmed significant improvement in diaphragmatic positioning and function.

Implications:

• Video-assisted thoracoscopic surgery (VATS) with diaphragmatic plication is a safe and effective treatment for infantile diaphragmatic eventration.
• This case represents the youngest infant reported to successfully undergo VATS for diaphragmatic eventration, highlighting the procedure's applicability in early infancy.
• Early diagnosis and surgical intervention can significantly improve outcomes for infants with diaphragmatic eventration, preventing long-term respiratory complications.