Eventration of the diaphragm in children

Diaphragmatic plication is a safe, well tolerated procedure for congenital diaphragmatic eventration. It is the treatment of choice in neonates with respiratory distress following phrenic nerve injury. The abdominal approach is as good as the thoracic and may be safer in cases with central eventration and when the diagnosis of congenital diaphragmatic hernia cannot be excluded with confidence. However, in phrenic nerve paralysis the thoracic approach is superior in showing the anatomical distribution of the phrenic nerve. Experience with eight paediatric patients treated for diaphragmatic eventration is reported. Five had congenital eventration of the diaphragm and three had acquired eventration. All patients except one required surgical plication of the diaphragm. Three patients developed minor postoperative complications and all patients were alive and well on follow-up. It appears that diaphragmatic plication is a safe and well tolerated procedure for symptomatic diaphragmatic eventration.