Congenital Diaphragmatic Eventration in the Neonatal Period: Systematic Review of the Literature and Report of a Rare Case Presenting with Gastrointestinal Disorders

Background: The term congenital diaphragmatic eventration (CDE) refers to an anatomical abnormality of the diaphragm. It is a very rare condition; however, early and prompt diagnosis is of very great importance due to possible life-threatening complications. Most severely affected patients are neonates, usually presented with respiratory distress symptoms. The aim of this study was to systematically review the existing literature and to consolidate data on CDE in neonates as well as to report a case of a neonate with congenital diaphragmatic eventration of the left hemidiaphragm and clinical signs and symptoms of the gastrointestinal tract. Methods: An electronic search of the PubMed and Scopus databases was performed regarding studies evaluating the clinical presentation, diagnosis methods, treatments, and outcomes of CDE in the neonatal population. Results: Data from 93 studies were integrated into our review, reporting 204 CDE cases, and according to them, the male/female ratio was 1/1 with a predominance of right-sided eventration. The diagnosis was primarily established by chest X-ray; surgical intervention was the most frequent treatment. The recurrence rate was 8.3% (9/109 cases). Conclusions: Early and accurate diagnosis of CDE and repair of the diaphragm can prevent complications, reduce morbidity, and improve the quality of patient’s life.

[1]  B. Sallout,et al.  Fetal Diaphragmatic Eventration: A Case report. , 2021, Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC.

[2]  C. Andrew,et al.  Fetal magnetic resonance imaging in the evaluation of congenital diaphragmatic anomalies , 2020, Egyptian Journal of Radiology and Nuclear Medicine.

[3]  S. Botden,et al.  Congenital diaphragmatic eventration and hernia sac compared to CDH with true defects: a retrospective cohort study , 2020, European Journal of Pediatrics.

[4]  Manish Kumar,et al.  Bilateral congenital eventration of diaphragm: keep in mind, the other side , 2018, BMJ Case Reports.

[5]  J. Bishara,et al.  Diaphragmatic Eventration Misdiagnosed as Diaphragmatic Hernia in a Preterm Infant , 2015 .

[6]  N. Zang,et al.  Congenital diaphragmatic eventration in children: 12 years' experience with 177 cases in a single institution. , 2015, Journal of pediatric surgery.

[7]  Richard D Riley,et al.  Preferred Reporting Items for a Systematic Review and Meta-analysis of Individual Participant Data: The PRISMA-IPD Statement , 2015 .

[8]  A. Al-Salem An Illustrated Guide to Pediatric Surgery , 2014 .

[9]  Michael F. McNeeley,et al.  Imaging of the diaphragm: anatomy and function. , 2012, Radiographics : a review publication of the Radiological Society of North America, Inc.

[10]  I. Hokuto,et al.  Diaphragm dysfunction with congenital cytomegalovirus infection , 2010, Journal of Perinatology.

[11]  A. Pimpalwar,et al.  Thoracoscopic plication for diaphragmatic eventration in a 3-month-old infant. , 2009, European journal of pediatric surgery.

[12]  Sarfaraz Nawaz,et al.  Eventration of the diaphragm and associations , 2007, Indian journal of pediatrics.

[13]  A. Şencan,et al.  Congenital eventration of the diaphragm in children: 25 years' experience in three pediatric surgery centers. , 2003, European journal of pediatric surgery : official journal of Austrian Association of Pediatric Surgery ... [et al] = Zeitschrift fur Kinderchirurgie.

[14]  K. Rieger,et al.  Twenty Years of Progress in Congenital Diaphragmatic Hernia at the University of Florida , 2003, The American surgeon.

[15]  A. Prescher,et al.  Surgical embryology and anatomy of the diaphragm with surgical applications. , 2000, The Surgical clinics of North America.

[16]  M. Yamaguchi,et al.  Diaphragmatic eventration in infants and children: is conservative treatment justified? , 1997, Journal of pediatric surgery.

[17]  C. Comstock,et al.  Eventration of the diaphragm. Prenatal diagnosis. , 1990, Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine.

[18]  B. Rodgers,et al.  Bilateral congenital eventration of the diaphragms: successful surgical management. , 1986, Journal of pediatric surgery.

[19]  F. Crawford,et al.  Diaphragmatic paralysis and eventration in infants. , 1986, The Journal of thoracic and cardiovascular surgery.

[20]  L. Reid,et al.  Pulmonary hypoplasia resulting from phrenic nerve agenesis and diaphragmatic amyoplasia. , 1980, The Journal of pediatrics.

[21]  A. Robinson,et al.  Bilateral anteromedial defect of the diaphragm in children. , 1980, AJR. American journal of roentgenology.

[22]  John B. Campbell,et al.  Eventration of the diaphragm. , 1974, Journal of pediatric surgery.

[23]  C. Hunt,et al.  Paralysis of the diaphragm. , 1974, American journal of diseases of children.

[24]  B. Reilly,et al.  Lung hypoplasia and membranous diaphragm in the congenital rubella syndrome--a rare case. , 1973, Journal of the Canadian Association of Radiologists.

[25]  E. Blasco,et al.  Diaphragmatic eventration in infants , 1973, Thorax.

[26]  M. Gyepes,et al.  Malfunction of the intact diaphragm in infants and children. , 1972, Archives of surgery.

[27]  T. V. Thomas Congenital eventration of the diaphragm. , 1970, The Annals of thoracic surgery.

[28]  R. Watson,et al.  Eventration of the diaphragm. Physiologic and surgical significance. , 1968, Archives of surgery.

[29]  R. B. Lynn,et al.  Surgery of eventration of the diaphragm. , 1956, The Journal of thoracic surgery.

[30]  Bisgard Jd Congenital eventration of the diaphragm. , 1947 .

[31]  J. A. Reed,et al.  EVENTRATION OF THE DIAPHRAGM: WITH A REPORT OF TWO CASES , 1935 .

[32]  E. Cutler,et al.  CONGENITAL DEFICIENCY OF THE DIAPHRAGM , 1924 .

[33]  S. Bayne-Jones EVENTRATION OF THE DIAPHRAGM: WITH REPORT OF A CASE OF RIGHT-SIDED EVENTRATION , 1916 .