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[Eventration of the diaphragm in infancy and childhood (author's transl)]
Insights
Diaphragmatic eventration in children, often congenital or traumatic, requires careful management. Most patients treated surgically or conservatively survived and showed long-term recovery.
Area of Science:
- Pediatric Surgery
- Thoracic Surgery
- Congenital Abnormalities
Context:
- Observational study of 31 pediatric patients with diaphragmatic eventration.
- Data collected between 1960 and 1975 at a university children's hospital.
- Focus on infants, with 27 of 31 cases under one year old.
Purpose:
- To analyze the causes, clinical presentation, and outcomes of diaphragmatic eventration in children.
- To evaluate the efficacy of both conservative and operative treatment strategies.
- To provide insights into indications for different management approaches.
Summary:
- Congenital hypoplasia (14 cases) and traumatic phrenic nerve paralysis (12 cases) were primary causes.
- 18 children underwent surgery, while 13 received conservative treatment.
- All but one patient survived, with long-term follow-up (3-15 years) assessing outcomes.
Impact:
- Highlights the importance of timely diagnosis and appropriate treatment for diaphragmatic eventration.
- Provides valuable data for surgical and pediatricians managing pediatric thoracic conditions.
- Contributes to understanding the long-term prognosis and management strategies for this condition.
Abstract:
31 children with eventration of the diaphragm were observed at the surgical department of the University Children's Hospital in Zürich from 1960 to 1975. 27 of the 31 children were less than one year old. In 14 of the cases the eventration was caused by a congenital hypoplasia of the diaphragm, in 12 by a traumatic paralysis of the phrenic nerve and in 3 cases it occurred postoperatively. 2 children had acquired the eventration later on in childhood. 18 of the 31 children were operated upon, 13 were treated conservatively. All except one survived and were examined again 3 to 15 years later. The various pathological anatomical forms, the clinical picture, signs and symptoms and the indication for conservative or operative treatment are discussed and illustrated by typical cases of the present series.