Diaphragmatic paralysis and eventration: newer approaches to diagnosis and operative correction

Positive contrast peritoneography allows the preoperative demonstration of the exact diaphragmatic contour in suspected eventration or paralysis. Anatomical appearances of bilateral elevation or infracardiac involvement will indicate the need for abdominal rather than transthoracic approach for repair. The use of peritoneography should permit rapid evaluation of newborns with respiratory distress and allow repair before long-standing respirator support has produced pulmonary parenchymal damage.