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EVENTRATION OF THE
DIAPHRAGM
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Eventration of the diaphragm, although not a true hernia, is characterized by
an elevated diaphragm that can lead to compression of the developing lung,
pulmonary hypoplasia, and post natal respiratory compromise.
It results from incomplete muscularization of the membranous diaphragm
during fetal life.
The herniated viscera are covered by a sac composed of abdominal peritoneal
layers as well as a thinned fibrous or muscular components of the diaphragm.
Link to Embryology
Link to Ultrasound
- Unilateral eventration of the
diaphragm has an increased incidence of rib anomalies, especially those on
the right side.
- Anteromedial on the
right side, total involvement on the left side.
- Right: left = 5:1.
- Bilateral eventration is
associated with:
- Chromosomal
abnormalities (trisomies 13, 15, 18) (1,2).
- Beckwith-Weiderman
syndrome.
- Congenital infection
(rubella, toxoplasmosis and cytomegalovirus).
- Arthrogryposis
multiplex congenita.
- Werdnig-Hoffman disease
(3).
- Adzick NS, Harrison MR, Glick
PL et.al. Diaphragmatic hernia in the fetus: Prenatal diagnosis and
outcome in 94 cases. J Pediatr Surg 1985;20:357-361.
- Benacerraf BR, Greene MF. Congenital
diaphragmatic hernia: US diagnosis prior to 22 weeks gestation. Radiology
1986;158:809-810.
- Liggins GC, Kitterman JA.
Development of the fetal lung. In: Elliot K, Whelan J (eds): The fetus and
independent life. London, Pittman Ciba Foundation Symposium
1981;86:308-322.