A one day old female infant was brought to the emergency room suffering from shortness of breath. An x-ray revealed the gastrointestinal tract in the right thoracic cavity. An emergency operation demonstrated eventration of the diaphragm, and a plication was performed. The baby was discharged without complication and has been followed up in the out patient clinic. Congenital diaphragmatic eventuation requiring emergency operation is rare.
Spontaneous rupture of the eventrated diaphragm is not common. The authors report a case of spontaneous rupture of the congenital diaphragmatic eventration. An 8 year-old girl with right congenital diaphragmatic eventration and nephrotic syndrome was seen in emergency room because of severe abdominal pain and vomiting. She had intermittent abdominal pain for 1 year. Plain chest X-ray and ultrasonography showed entrapped bowels in the right thoracic area. Exploratory laparotomy revealed a ruptured right eventration. THE displaced abdominal viscera were repositioned into the abdominal cavity and the ruptured diaphragm was trimmed and plicated. The postoperative course was uneventful. Only one case of spontaneous rupture of eventrated diaphragmatic has been reported in the English literature.
Although diaphragmatic eventration in newborn infants is generally regarded as a rare condition, the need for accurate diagnosis and appropriate intervention according to the etiological factors is well known. Recently the authors experienced five consecutive cases of diaphragmatic eventration below the age of two months(one to 55 days) requiring surgery. All were in males, and were left sided. Respiratory symptoms were present in 4 patients, and one patient showed inability to gain weight. Diaphragms were elevated to the level of the third to fifth intercostal spaces. Diaphragmatic plication through the abdomen gave excellent results. There was no postoperative mortality.