scholarly journals Bilateral diaphragmatic paralysis after kidney surgery

2015 ◽  
Vol 77 (2) ◽  
Author(s):  
S. Sozzo ◽  
P. Carratù ◽  
M.F. Damiani ◽  
V.A. Falcone ◽  
A. Palumbo ◽  
...  
Keyword(s):  
Turner Syndrome ◽  
Phrenic Nerve ◽  
Diaphragmatic Paralysis ◽  
Transdiaphragmatic Pressure ◽  
Neuralgic Amyotrophy ◽  
X Ray ◽  
Post Surgery ◽  
Diaphragm Paralysis ◽  
Chest X Ray ◽  
Kidney Angiomyolipoma

A 57-year-old woman underwent an enucleoresection of her right kidney angiomyolipoma. Two weeks later she was admitted to our hospital because of dyspnea at rest with orthopnea. The chest x-ray showed the elevation of both hemidiaphragms and the measurement of the sniff transdiaphragmatic pressure confirmed the diagnosis of bilateral diaphragmatic paralysis. A diaphragm paralysis can be ascribed to several causes, i.e. trauma, compressive events, inflammations, neuropathies, or it can be idiopathic. In this case, it was very likely that the patient suffered from post-surgery neuralgic amyotrophy. To our knowledge, there are only a few reported cases of neuralgic amyotrophy, also known as Parsonage- Turner Syndrome, which affects only the phrenic nerve as a consequence of a surgery in an anatomically distant site.

Management of an unusual presentation of foreign body aspiration

1992 ◽  
Vol 106 (8) ◽  
pp. 751-752 ◽  
Author(s):  
Hassan H. Ramadan ◽  
Nicolas Bu-Saba ◽  
Anis Baraka ◽  
Salman Mroueh
Keyword(s):  
Foreign Body ◽  
Subcutaneous Emphysema ◽  
Positive Pressure Ventilation ◽  
Intermittent Positive Pressure Ventilation ◽  
Foreign Body Aspiration ◽  
Positive Pressure ◽  
Review Of The Literature ◽  
X Ray ◽  
Post Surgery ◽  
Chest X Ray

AbstractForeign body aspiration is a very common problem in children and toddlers and still a serious and sometimes fatal condition. We are reporting on a 2-year-old white asthmatic male who choked on a chick pea and presented with subcutaneous emphysema, and on chest X-ray with an isolated pneumomediastinum but not pneumothorax. On review of the literature an isolated pneumomediastinum without pneumothorax was rarely reported. This presented a challenge in management mainly because of the technique that we had to use in order to undergo bronchoscopy and removal of the foreign body. Apnoeic diffusion oxygenation was used initially while the foreign body was removed piecemeal, and afterwards intermittent positive pressure ventilation was used. The child did very well, and his subcutaneous emphysema and pneumomediastinum remarkably improved immediately post surgery.

scholarly journals Lifelong Idiopathic Unilateral Diaphragmatic Paralysis With Recurrent Pneumonia: A Case Report

2020 ◽  
Vol 10 (1) ◽  
pp. 26743
Author(s):  
Khosrow Agin ◽  
Akram Sabkara ◽  
Farzaneh Sadat Mirsafai Rizi ‎ ◽  
Bita Dadpour ◽  
Maryam Vahabzadeh ◽  
...  
Keyword(s):  
Primary Diagnosis ◽  
Diaphragmatic Paralysis ◽  
Recurrent Pneumonia ◽  
Emergency Center ◽  
Diabetes Mellitus Type Ii ◽  
X Ray ◽  
Breath Sounds ◽  
History Of ◽  
Chest X Ray ◽  
The Right

A 50-year-old woman was admitted to the emergency center with dyspnea, cough, and fever symptoms. She had a medical history of diabetes mellitus type II, rheumatoid arthritis, as well as several admission records due to aspiration pneumonia. The primary diagnosis was diabetic ketoacidosis and pneumonia. Normal breath sounds were reduced on the lower posterior right side of the thorax. A standard chest x-ray and lung Computed Tomography (CT) scan revealed collapse consolidation in the Right Lower Lobes (RLL) and Right Middle Lobes (RML). We here presented a case of unilateral diaphragmatic paralysis with a history of recurrent pneumonia.

scholarly journals Use of Noninvasive Ventilation with Volume-Assured Pressure Support in Neuralgic Amyotrophy with Bilateral Diaphragmatic Paralysis

2019 ◽  
Vol 13 (1) ◽  
pp. 45-47
Author(s):  
Montserrat Diaz-Abad ◽  
Neil Porter ◽  
Lindsay Zilliox ◽  
Nevins Todd
Keyword(s):  
Noninvasive Ventilation ◽  
Phrenic Nerve ◽  
Pressure Support ◽  
Disease Onset ◽  
Shoulder Girdle ◽  
Acute Onset ◽  
Diaphragmatic Paralysis ◽  
Brachial Plexopathy ◽  
Neuralgic Amyotrophy ◽  
Nerve Involvement

Neuralgic Amyotrophy (NA) is a rare, acute onset inflammatory brachial plexopathy that frequently presents with acute pain followed by shoulder girdle muscle weakness. Phrenic nerve involvement affecting the diaphragms occurs in 7-10% of cases. We present the case of a 52-year-old man with neuralgic amyotrophy with phrenic nerve involvement and bilateral diaphragmatic paralysis with marked respiratory symptoms and sleep hypoventilation, who was treated with non-invasive ventilation with volume assured pressure support mode. By 21 months post disease onset, the patient had experienced marked improvement in orthopnea, sleep quality and functional status. This is the first reported case of the use of this mode of noninvasive ventilation in neuralgic amyotrophy.

Phrenic Nerve Involvement in Neuralgic Amyotrophy (Parsonage-Turner Syndrome)

2020 ◽  
Vol 15 (4) ◽  
pp. 539-543
Author(s):  
Ellen Farr ◽  
Dom D’Andrea ◽  
Colin K. Franz
Keyword(s):  
Turner Syndrome ◽  
Phrenic Nerve ◽  
Neuralgic Amyotrophy ◽  
Nerve Involvement

Respiratory responses in reversible diaphragm paralysis

1981 ◽  
Vol 51 (5) ◽  
pp. 1150-1156 ◽  
Author(s):  
M. L. Nochomovitz ◽  
M. Goldman ◽  
J. Mitra ◽  
N. S. Cherniack
Keyword(s):  
Electrical Activity ◽  
Tidal Volume ◽  
Phrenic Nerve ◽  
Respiratory Activity ◽  
Vagus Nerves ◽  
Inspiratory Time ◽  
Transdiaphragmatic Pressure ◽  
Co2 Partial Pressure ◽  
Diaphragm Paralysis ◽  
Before And After

The effects of diaphragm paralysis on respiratory activity were assessed in 13 anesthetized, spontaneously breathing dogs studied in the supine position. Transient diaphragmatic paralysis was induced by bilateral phrenic nerve cooling. Respiratory activity was assessed from measurements of ventilation and from the moving time averages of electrical activity recorded from the intercostal muscles and the central end of the fifth cervical root of the phrenic nerve. The degree of diaphragm paralysis was evaluated from changes in transdiaphragmatic pressure and reflected in rib cage and abdominal displacements. Animals were studied both before and after vagotomy breathing O2, 3.5% CO2 in O2, or 7% CO2 in O2. In dogs with intact vagi, both peak and rate of rise of phrenic and inspiratory intercostal electrical activity increased progressively as transdiaphragmatic pressure fell. Tidal volume decreased and breathing frequency increased as a result of a shortening in expiratory time. Inspiratory time and ventilation were unchanged by diaphragm paralysis. These findings were the same whether O2 or CO2 in O2 was breathed. After vagotomy, no significant change in phrenic or inspiratory intercostal activity occurred with diaphragm paralysis in spite of increased arterial CO2 partial pressure. Ventilation and tidal volume decreased significantly, and respiratory timing was unchanged. These results suggest that mechanisms mediated by the vagus nerves account for the compensatory increase in respiratory electrical activity during transient diaphragm paralysis. That inspiratory time is unchanged by diaphragm paralysis whereas the rate or rise of phrenic nerve activity increases suggest that reflexes other than the Hering-Breuer reflex contribute to the increased respiratory response.

scholarly journals Surgery of Eventration of the Diaphragm

2021 ◽  
Vol 63 (2) ◽  
pp. 57-59
Author(s):  
Waleed M. Hussen ◽  
Ahmed M. Mohammed ◽  
Akeel S. Yuser
Keyword(s):  
Phrenic Nerve ◽  
Surgical Repair ◽  
Female Ratio ◽  
X Ray ◽  
Presenting Symptoms ◽  
Left Hemidiaphragm ◽  
Eventration Of Diaphragm ◽  
Chest X Ray ◽  
Male To Female ◽  
Eventration Diaphragm

Abstract Background: Eventration of diaphragm is an abnormal elevation of the diaphragm. Publishing on eventration of diaphragm in Iraq is scarce. Objective: This study was carried out to report on the Iraqi experience on eventration of diaphragm. Methods: A total of 18 patients with eventration diaphragm were included in this study. A review of case records of patients with eventration diaphragm treated in Ibn Al-Nafees Teaching Hospital was done. Review of records took place for the period of March 2012 to Dec. 2017. Results: The age of patients was ranged 5 months to 70 years, giving male to female ratio of 2:1. Dyspnea was dominating presenting symptoms followed by cough. The left hemidiaphragm was the most affected site (83.3%). The cause of eventration of diaphragm was idiopathic in 72.2% of patients. Chest X ray showed the elevation of the affected hemidiaphragm. CT scan demonstrated the thinned-out raised hemidiaphragm. The most common complications were atelectasis, and recurrent chest infection. Hospital stay was ranging 4-14 days. Conclusion: Eventration of diaphragm is not uncommon in Iraq. Presentation, management, and complication are similar to that reported in global centers.   Key words:  Diaphragm. Eventration.  Plication. Surgical repair. Phrenic nerve injury  

scholarly journals Elevated Hemidiaphragm and Shortness of Breath: Challenges in Clinicoradiologic Integration

2018 ◽  
Vol 4 (3-4) ◽  
pp. 223-229
Author(s):  
Vivek Podder ◽  
Rakesh Biswas ◽  
Nidhi Sehgal
Keyword(s):  
Chest Radiography ◽  
Systolic Function ◽  
High Sensitivity ◽  
Diaphragmatic Paralysis ◽  
Peak Exercise ◽  
X Ray ◽  
St Segment ◽  
History Of ◽  
Chest X Ray ◽  
Rule Out

Unilateral diaphragmatic paralysis is often suspected when a hemidiaphragm is found abnormally elevated on chest radiography. Chest radiography has a high sensitivity for diaphragmatic palsy. A 67-year-old male presented to the hospital with a history of 4 months of exertional breathlessness that improved after taking a rest. The patient had normal cardiac and respiratory physical function. He also had a normal electrocardiogram and good systolic function on echocardiography. A treadmill test revealed ST-segment changes during peak exercise and recovery phases. On chest X-ray, his right hemidiaphragm was shown to be significantly elevated. Further investigation was conducted to rule out diaphragmatic paralysis, and the findings took a surprising turn to an entirely different diagnosis.

scholarly journals Explorations of Unilateral Diaphragmatic Paralysis

2014 ◽  
Vol 2014 ◽  
pp. 1-6 ◽  
Author(s):  
Alexandre Quesnel ◽  
Françoise Beuret Blanquart ◽  
Jean Paul Marie ◽  
Eric Verin
Keyword(s):  
Nerve Stimulation ◽  
Phrenic Nerve ◽  
Esophageal Pressure ◽  
Diagnostic Value ◽  
Diaphragmatic Paralysis ◽  
Inspiratory Pressure ◽  
Maximal Inspiratory Pressure ◽  
Phrenic Nerve Stimulation ◽  
Diaphragmatic Dysfunction ◽  
Chest X Ray

Objective. The aim of the present study was to evaluate sniff test, maximal inspiratory pressure, and presence of paradoxical inspiratory diaphragmatic movements and their diagnostic value in patients referred for suspicion of diaphragmatic dysfunction. Methods. Twenty-two patients (8 men and 14 women, 58±13 years) with suspected diaphragmatic dysfunction were included. Pulmonary function test was evaluated by spirometry. Diaphragm dysfunction was diagnosed with unilateral phrenic nerve stimulation. Esophageal pressure was recorded during sniff test and maximal static inspiratory movements. Detection of paradoxical diaphragmatic movement was performed with anteroposterior projection of chest X-ray fluoroscopic video. Results. Phrenic nerve stimulation enabled diagnosis of diaphragmatic paralysis in 15 of the 22 patients. The remaining 7 patients had normal explorations. Lung volumes were significantly lower in patients with diaphragmatic paralysis than in control subjects, as maximal inspiratory pressure. No patient with normal diaphragmatic exploration had paradoxical inspiratory movement. The combined diagnostic value of reduced esophageal pressure during sniff test, reduced esophageal pressure during maximal static inspiratory movements, and presence of paradoxical inspiratory movement had a sensitivity of 87% and a specificity of 71%. Conclusion. Our results suggest that, in most cases, a combination of sniff test, maximal inspiratory pressure, and paradoxical inspiratory movement could help to diagnose diaphragmatic dysfunction. Nevertheless, phrenic nerve stimulation remains the best test for assessing diaphragmatic dysfunction.

scholarly journals Bochdalek Hernia

2018 ◽  
Vol 2 (2) ◽  
pp. 40
Author(s):  
Yuliaji Narendra Putra ◽  
Tubagus Odih Rhomdani Wahid ◽  
Guntur Surya Alam ◽  
Rohadi Rohadi
Keyword(s):  
Abdominal Cavity ◽  
Good Condition ◽  
Left Lung ◽  
Favourable Result ◽  
Thoracic Cavity ◽  
Bochdalek Hernia ◽  
X Ray ◽  
Post Surgery ◽  
Abdominal Organs ◽  
Chest X Ray

Background: Bochdalek hernia is a congenital defect on posterolateral diaphragm with an abnormal connection between the thoracic cavity and the abdominal cavity. This disease causes protrusion of abdominal organs into the thoracic cavity. Case: an 8-day-old baby girl admitted to hospital with shortness of breath 24 hours after delivered. The baby was born spontaneously assisted by midwife. Upon born, the baby was crying strongly and meconium came out 2 hours after birth. On physical examination, the abdomen was inspected flat. Darm contour and darm steifung was observed, and peristaltic sound was heard on left lung. Radiological examination demonstrated a diaphragmatic hernia with ileus obstruction. The patient underwent laparatomy and stomach, ileum, transverse colon, and spleen, was found on foramen Bochdalek. Post-surgery chest X Ray showed favourable result. Ten days after treatment, the patient was discharged in a good condition with no respiratory or digestive problems. After 1 months the patient’s condition remained good and there were no respiratory or digestive complaints. Conclusion: In a rare case like Bochadalek hernia, laparotomy performed as a promising attempt to return the anatomic position of organ.

scholarly journals Herpes zoster complicated by phrenic nerve palsy and respiratory compromise

2019 ◽  
Vol 19 (3) ◽  
pp. 2347-2350
Author(s):  
Paska Apiyo ◽  
Jan Hajek
Keyword(s):  
Herpes Zoster ◽  
Phrenic Nerve ◽  
Nerve Palsy ◽  
Neck Region ◽  
Neurologic Complication ◽  
Respiratory Compromise ◽  
Phrenic Nerve Palsy ◽  
X Ray ◽  
Chest X Ray ◽  
New Onset

Background: Herpes zoster can be associated with severe neurological complications.Case presentation: In this article, we describe the case of a 54-year-old man with herpes zoster affecting his right upper chest and neck region complicated by phrenic nerve palsy and respiratory compromise. The diagnosis of herpes zoster was made based on the classic appearance of the rash and associated neuropathic-type pain. The diagnosis of phrenic nerve palsy was made by chest x-ray and ultrasound.Conclusion: Clinicians should be aware of the possibility of phrenic nerve palsy occurring in patients who have herpes zoster affecting the region of C3,4,5 dermatomes. Although symptoms of unilateral diaphragmatic paresis are usually mild, in patients with obesity or comorbid lung disease, new onset phrenic nerve palsy can lead to significant respiratory compromise.Keywords: Herpes zoster, neurologic complication, phrenic nerve palsy, case report.

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