[Diaphragmatic eventration in pediatric age: indications to surgery and results]

Indication for surgical treatment and its results are reported in 17 consecutive cases of diaphragmatic eventration in pediatric age. Fourteen of the patients are males and 3 are females. Eleven of them had a right eventration 6 had a left eventration. Three of the patients were new-born, 13 were aged from 6 months to 3 years and 1 was aged 6 years. Two patients had gastroesophageal reflux, 1 had right intralobar pulmonary sequestration, and another had inguinal hernia. In 2 of the new-born the eventration was caused by a phrenic nerve palsy (in 1 case resulting from birth trauma, while in the other one resulting from multiple thoracentesis). In this last patient surgical treatment wasn't performed, and restitutio ad integrum was observed in 4 weeks' time. The indication for surgical treatment in 2 new-born patients was persistent polypnoea and dyspnoea unresponsive to medical treatment, in 12 of the patients were relapsing bronchitis and bronchopneumonia. Moreover 1 patient with few symptoms but with important diaphragmatic eventration was operated. In all the patients a diaphragmatic plication with fixing of the diaphragmatic plica to the ribs was performed through a thoracic approach. Neither complication or deaths were noticed. There was an immediate remission of the symptomatology in all the cases examined. No relapse of eventration or restarting of the symptomatology was found during a follow-up for a period of 2 to 8 years.