Eventration: What It Is and How It Is Treated

Written by Medicover Team and Medically Reviewed by Dr Nitin Dasharath Tawte , General Surgeons

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1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

Eventration of the diaphragm is a relatively rare condition in which part or all of the diaphragm becomes abnormally elevated because the muscle is weakened, thinned, or poorly developed. It may be present from birth or develop later in life.

Eventration can sometimes resemble a diaphragmatic hernia on imaging. However, the diaphragm remains intact in eventration, whereas a diaphragmatic hernia involves an actual opening or defect in the diaphragm. Depending on its severity, eventration may cause breathing difficulties, reduced exercise tolerance, or digestive discomfort, although some people have no symptoms.

What are the Types of Eventration of the Diaphragm?

Eventration of the diaphragm is generally classified according to whether it is present from birth or develops later in life.

Congenital Eventration: Present from birth and usually caused by abnormal development or thinning of the diaphragmatic muscle.
Acquired Eventration: Develops later in life and may occur because of phrenic nerve injury, trauma, surgery, or neuromuscular disorders affecting diaphragm function.

The condition may affect one side of the diaphragm, most commonly the right or left hemidiaphragm, or involve a larger portion of the diaphragm.

What are the Symptoms and Warning Signs of Eventration?

Symptoms depend on how much the diaphragm is elevated and whether lung expansion or abdominal organ function is affected. Some people have no symptoms, while others may experience respiratory or digestive problems.

Common Symptoms

Shortness of breath: Difficulty breathing, particularly during physical activity or when lying down.
Reduced exercise tolerance: Becoming tired or breathless more easily during physical activity.
Chest discomfort: Pressure or discomfort may occur in some individuals.
Abdominal discomfort: The elevated diaphragm may affect the position or function of nearby abdominal organs.
Fatigue: Reduced breathing efficiency may contribute to tiredness.

Severe Symptoms

Significant breathing difficulty
Low oxygen levels in severe cases
Marked limitation of physical activity
Difficulty breathing when lying flat

What are the Causes and Risk Factors of Eventration of the Diaphragm?

Eventration occurs when the diaphragm becomes abnormally thin, weak, or unable to contract normally. The cause may be congenital or acquired.

Causes of Eventration

Congenital abnormalities: Abnormal development of the diaphragm before birth can result in a thin or underdeveloped muscle.
Phrenic nerve injury: Damage to the nerve that controls the diaphragm can impair diaphragmatic movement.
Trauma: Chest or abdominal injuries may damage the diaphragm or its nerve supply.
Surgical procedures: Surgery involving the chest, neck, or upper abdomen may occasionally affect the phrenic nerve or diaphragm.
Neuromuscular disorders: Certain conditions affecting nerves or muscles can weaken diaphragmatic function.
Infections or inflammation: Some conditions affecting the phrenic nerve or surrounding tissues may contribute to diaphragmatic dysfunction.

Risk Factors

Previous chest or upper abdominal surgery
Chest or abdominal trauma
Conditions affecting the phrenic nerve
Neuromuscular disorders
Congenital abnormalities of the diaphragm

When to See a Doctor?

Consult a General Surgeon. Medical evaluation is recommended when symptoms suggest that an elevated diaphragm may be affecting breathing or daily activities.

Persistent or worsening shortness of breath
Breathlessness during routine activities
Difficulty breathing when lying down
Persistent chest or abdominal discomfort
Reduced exercise tolerance or unexplained fatigue
Breathing problems following chest or abdominal surgery or trauma

Severe or sudden breathing difficulty, bluish lips or skin, or symptoms associated with a serious chest injury require urgent medical attention.

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How is Eventration of the Diaphragm Diagnosed?

Diagnosis involves evaluating the position and movement of the diaphragm and determining whether another condition, such as a diaphragmatic hernia or paralysis, is responsible for the abnormal elevation.

Diagnostic Tests

Chest X-ray: Often the initial investigation and can show an abnormally elevated diaphragm.
Ultrasound: Helps assess diaphragm thickness and movement in real time.
CT scan: Provides detailed images of the diaphragm and surrounding organs and can help distinguish eventration from a diaphragmatic hernia.
MRI: May be used when detailed evaluation of the diaphragm, nerves, or surrounding structures is required.
Pulmonary function tests: May be performed to determine whether the elevated diaphragm is affecting lung function.
Diaphragm movement testing: Specialized imaging may help assess whether the diaphragm is moving normally.

Accurate diagnosis is important because an elevated diaphragm can have several causes, and treatment depends on the underlying problem and severity of symptoms.

What are the Treatment Options for Eventration of the Diaphragm?

Treatment depends on the severity of symptoms, the cause of eventration, and its effect on breathing. People without significant symptoms may only need observation, while symptomatic patients may require surgical treatment.

Conservative Management

Observation: Asymptomatic or mildly symptomatic patients may require regular monitoring rather than immediate treatment.
Respiratory therapy: Breathing exercises and pulmonary rehabilitation may help improve respiratory function in selected patients.
Treatment of underlying conditions: Managing neuromuscular disorders or other contributing conditions may improve symptoms.

Surgical Treatment

Surgery may be considered when eventration causes significant breathing problems, reduced quality of life, or persistent symptoms despite conservative treatment.

Diaphragmatic plication: The weakened or elevated diaphragm is folded and sutured to flatten it and improve lung expansion. It is the most commonly used surgical treatment for symptomatic eventration.
Thoracoscopic surgery: A minimally invasive approach that uses small incisions in the chest to perform diaphragmatic plication.
Laparoscopic surgery: In selected patients, the diaphragm can be accessed through the abdomen using minimally invasive techniques.

Postoperative Care

Respiratory exercises to promote lung expansion
Pain management as recommended by the medical team
Gradual return to physical activity
Follow-up examinations to assess diaphragm and lung function

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What is the Recovery Process After Eventration Treatment?

Recovery depends on the severity of eventration, the treatment performed, and the individual's overall health. Patients undergoing diaphragmatic plication generally require follow-up to assess breathing and lung expansion.

After Surgery

Follow the prescribed respiratory exercises and rehabilitation plan.
Gradually increase physical activity according to medical advice.
Attend scheduled follow-up appointments.
Take prescribed medications as directed.
Report persistent or worsening breathing difficulties to the treating doctor.

Long-Term Outlook

Many people with mild or asymptomatic eventration have a good long-term outlook and may not require surgery. In symptomatic patients, diaphragmatic plication can improve lung expansion, breathing symptoms, and exercise tolerance in appropriate cases.

What Precautions Can Help Prevent Eventration of the Diaphragm?

Congenital eventration cannot be prevented. However, reducing the risk of acquired diaphragm or phrenic nerve injury and managing underlying conditions may help reduce complications.

Prevention

Take appropriate precautions to prevent chest and abdominal injuries.
Follow medical advice after chest or upper abdominal surgery.
Manage underlying neuromuscular conditions appropriately.
Seek medical evaluation for persistent breathing difficulties.
Attend follow-up appointments when diaphragm dysfunction has been diagnosed.

Complications

Severe or untreated symptomatic eventration may contribute to:

Reduced lung capacity
Persistent shortness of breath
Reduced exercise tolerance
Difficulty breathing when lying down
Reduced quality of life

Our Experience Treating Eventration of the Diaphragm

At Medicover Hospitals, patients with eventration of the diaphragm receive individualized evaluation and treatment based on their symptoms, diaphragm function, and underlying cause.

Our multidisciplinary team uses diagnostic imaging and respiratory assessments to distinguish eventration from other conditions that can cause an elevated diaphragm. When surgery is appropriate, minimally invasive approaches such as diaphragmatic plication may be considered to improve diaphragm position and lung expansion.

With appropriate diagnosis, treatment, and follow-up, many patients can achieve improved breathing, activity levels, and quality of life.

Frequently Asked Questions

1. What is diaphragmatic eventration?

Diaphragmatic eventration is a condition in which part or all of the diaphragm is abnormally elevated because the muscle is weak or underdeveloped.

2. What are the symptoms of diaphragmatic eventration?

Symptoms may include shortness of breath, rapid breathing, chest discomfort, recurrent respiratory infections, or reduced exercise tolerance. Some people have no symptoms.

3. What causes diaphragmatic eventration?

It may be congenital or develop later due to damage or weakness of the phrenic nerve or diaphragm muscle.

4. How is diaphragmatic eventration diagnosed?

Diagnosis may involve a chest X-ray, ultrasound, CT scan, or tests that assess diaphragm movement.

5. How is diaphragmatic eventration treated?

Mild cases may only require monitoring and treatment of respiratory symptoms. Severe symptomatic cases may require surgical diaphragmatic plication to improve breathing.