Diagnosis and therapy of adult diaphragmatic eventration:a report of 26 cases / 解放军医学杂志

ABSTRACT

Objective To summarize the characteristics on diagnosis and therapy of adult diaphragmatic eventration. Method The clinical data of 26 patients with adult diaphragmatic eventration, hospitalized in General Hospital of PLA from 1988 to 2009, were retrospectively analyzed. The 26 patients, 14 males and 12 females, were aged from 26 to 66 (mean 44.0?5.7), with disease course of 8 months to 17 years. Among them 25 suffered from left and 1 from right diaphragmatic eventration; 24 with total and 2 with localized diaphragmatic eventration; of them 2 without symptoms were detected in physical examination, and among the 24 remainders 18 were with the symptoms of thoracic discomfort after eating, 8 with dyspnea after activities, 14 with hiccup, vomiting and abdominal discomfort. Most of the patients had more than one symptom. All patients received operations via the chest cavity under general anesthesia, 24 cases were performed by double mattress suture with diaphragm discission, while 2 cases by fold suture without diaphragm discission. Results Symptoms relief was reported in 24 patients at the early stage after operation. Eighteen patients were followed up for one year, and 15 of them received chest radiograph, among whom the normal diaphragm localization were in 13 cases and relatively higher diaphragm localization in 2 cases, while the other 3 patients received no re-examination of chest radiograph. Among the 18 cases receiving one year of follow-up, 10 cases got complete disappearance of symptoms, 6 cases got symptoms relieved or partially disappeared, and 2 patients got symptom relapsed. Conclusion Surgical outcome, especially the double mattress suture is satisfactory for adult diaphragmatic eventration.