Diaphragm eventration refers to an abnormal placement of the diaphragm - the main muscle involved in breathing that is normally found below the lungs. In diaphragm eventration, the diaphragm is located too high in the body, either due to issues with the nerves that supply the muscle, or the muscle itself. In more severe cases, this can compress the lungs and interfere with breathing.
Most cases of diaphragm eventration can be present at birth (congenital) or develop due to injury, trauma, or an infection. The diaphragm is supplied by an important nerve called the phrenic nerve; if this nerve is injured, the diaphragm can shift upward and the muscle replaced with fibroelastic, stiff tissue over time, leading to diaphragm eventration.
Those with diaphragm eventration often experience none, or very few, symptoms. When they occur, symptoms of diaphragm eventration include:
- Difficulty breathing, especially with exercise or when lying down
- Chest pain
- Recurrent pneumonias
- Cardiac arrhythmias
Sometimes, especially in those without severe symptoms, diaphragm eventration can be an incidental finding during an x-ray. In addition to imaging studies, breathing is typically assessed using pulmonary function testing to determine the degree to which respiration is compromised.
In more mild cases of diaphragm eventration, treatment can be non-surgical, and include physical therapy and pulmonary rehabilitation to improve breathing. If symptoms persist, a surgery called diaphragmatic plication may be the best option. Diaphragm plication is when the diaphragm is surgically put into its proper place to allow enough room for the lungs to breathe properly.