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International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure
05:50

International Expert Consensus and Recommendations for Neonatal Pneumothorax Ultrasound Diagnosis and Ultrasound-guided Thoracentesis Procedure

Published on: March 12, 2020

Eventration of the diaphragm in infants and children

H Obara, H Hoshina, S Iwai

    Acta Paediatrica Scandinavica
    |July 1, 1987
    PubMed

    Insights

    Early diaphragmatic plication surgery is recommended for infants and children with eventration of the diaphragm. This intervention can reduce lung pathologies like atelectasis and pneumonia, especially in acquired cases.

    Area of Science:

    • Pediatric Surgery
    • Pulmonology
    • Pathology

    Background:

    • Eventration of the diaphragm is a condition affecting infants and children, characterized by impaired diaphragm movement.
    • It can lead to significant pulmonary complications, with severity increasing with age.

    Purpose of the Study:

    • To review clinical outcomes and microscopic findings in pediatric patients with eventration of the diaphragm.
    • To evaluate the efficacy of surgical diaphragmatic plication in mitigating associated lung pathology.

    Main Methods:

    • Retrospective review of 18 infants and children treated for diaphragm eventration over eight years.
    • Classification into congenital and acquired types based on Thomas' criteria.
    • Microscopic examination (light and electron microscopy) of diaphragm and lung tissues.
    • Surgical diaphragmatic plication performed in 15 patients.

    Main Results:

    • Congenital eventration showed diffuse fibroelastic tissue in the diaphragm.
    • Acquired eventration exhibited muscle degeneration and interstitial fibrosis, worsening with age.
    • Lung biopsies revealed atelectasis and pneumonia, more severe in older children.
    • Surgical plication was performed on 15 patients.

    Conclusions:

    • Early surgical intervention, including diaphragmatic plication, is advised for both congenital and acquired eventration.
    • Prompt surgery can help prevent or reduce progressive lung damage such as atelectasis and pneumonia.
    • Consideration for surgery should be based on the presence of respiratory and digestive symptoms.

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