Diaphragmatic eventration is referred to surgeons for plication not uncommonly by the intensivists as they are unable to wean the infants from the ventilator. The persistent elevation and paradoxical movements clinically, on fluoroscopy and on ultrasound, are diagnostic of paralysed diaphragm. The reduced thoracic capacity and paradoxical movement of the diaphragm, persistent collapse of the lower lobe or recurrent infection in the collapsed lung are indications for surgical intervention in children. Typically, these infants fail to thrive and are breathless on exertion and prone to recurrent chest infections in the collapsed lobe. Plication can be easily achieved thoracoscopically with minimal morbidity. Recurrence generally is rare but is seen in children with syndromes or associated with myopathy and/or poor muscle tone.
KeywordsDiaphragmatic eventration Thoracoscopy Plication Diaphragmatic pacing Diaphragmatic hernia with hernia sac