A Case Series on Unilateral Elevation of Diaphragm

We report a case series of seven patients aged 24 to 78 years who presented with unilateral elevation of the diaphragm secondary to diverse underlying mechanisms. The diagnoses included sarcoidosis-related pulmonary inflammation, gallbladder adenomyomatosis with sepsis and metabolic derangement, pulmonary tuberculosis with Chilaiditi's syndrome, acute pulmonary embolism with diaphragmatic eventration, superior vena cava syndrome due to non-small cell lung carcinoma, cryptogenic organizing pneumonia with an incidental thymic cyst and pyogenic liver abscess. This series emphasizes that unilateral diaphragmatic elevation should not be attributed only to phrenic nerve injury or primary diaphragmatic paralysis; pulmonary, abdominal, vascular, mediastinal and inflammatory causes should also be systematically evaluated. Early identification and treatment of the primary disorder resulted in clinical improvement and radiological normalization in most reversible cases.