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Volume 13 Issue 3 (March) 2024

Original Articles

Management of diaphragmatic eventration—A single centre experience
Dr. M. Karthikeyan, Dr. M. Uma Maheswaran, Dr. Krishnabharath, Dr. Benet Duraisamy, Dr. P. Saravanaboopathy, Dr. Sachin Karthik

Introduction: The diaphragm is a fibromuscular organ whose primary function is related to ventilation. It also serves as a barrier between pleural and abdominal cavities. This organ is rarely affected by pathologic entities, but eventration is among the primary diseases of this structure. Methods: This case series includes 10 patients diagnosed and managed as diaphragmatic eventration in Department of Surgical gastroenterology, Tirunelveli Medical College. All data were retrospectively collected. Results: There were a total of 6(60%) male patients and 4 (40%) female patients. (90%) patients had left sided diaphragmatic eventration Among the 10 patients, 8 (80%) were symptomatic and hence managed with surgery. Laparoscopic diaphragmatic repair was done in 5 (50%) patients. Laparotomy was done in 3(30%) patients. Remaining 2(20%) patients were asymptomatic and were managed conservatively. Postoperatively all patients were managed with Non invasive mode of ventilation, spirometery and respiratory exercises. None of the patients had a recurrence on regular follow-up. Conclusion: Diaphragmatic eventration is quite rare. All symptomatic patients have to be managed surgically. Surgical options include laparotomy and minimally invasive laparoscopy and thoracoscopy. Laparoscopy is better in terms of better intra-op exposure, postop recovery and postop pain relief. Diaphragmatic plication with barbed sutures seems to provide good results in terms of symptomatic relief and recurrence.

 
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