Diaphragmatic Pathology in Children: Not Always an Easy Diagnosis

We present a rare case of a 10-year-old boy with a right diaphragmatic eventration (DE), an uncommon pathology in children. The case highlights the importance of making a correct differential diagnosis between an acquired diaphragmatic hernia and a DE, two uncommon diaphragmatic pathologies. Differential diagnosis of these two entities can usually be made based on radiological findings, by identifying the continuity or the lack of continuity of the diaphragm, but sometimes, especially when on the right side, like in our case, they can be very difficult to differentiate by imaging. Diaphragmatic eventration is an abnormal elevation of an intact diaphragm that maintains its continuity and its attachments to the costal wall. Diaphragmatic hernia occurs when abdominal organs move into the chest through a defect in the diaphragm. Diaphragmatic hernia is generally symptomatic and always a medical emergency and requires urgent surgery, whereas DE is generally asymptomatic, has a better prognosis, and can be treated conservatively.As the treatment, the surgical approach, and the prognosis of these two entities are very different, a correct differential diagnosis is very important.