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Diaphragmatic eventration

Diaphragmatic eventration refers to an abnormal contour of the diaphragmatic dome. It typically affects only a segment of the hemidiaphragm, compared to paralysis/weakness where the entire hemidiaphragm is typically affected. 

Pathology

Diaphragmatic eventration is congenital in nature and due to incomplete muscularisation of the diaphragm with a thin membranous sheet replacing normal diaphragmatic muscle. Over time this region stretches and on inspiration does not contract normally. 

Location

Frequently eventration is seen in the a anteromedial portion of the right hemidiaphragm.

Radiographic features

Plain film

Elevation of the affected portion of the diaphragm is usually seen as a smooth hump, while the remainder of the hemidiaphragm contour is normal.

CT
  • may be a sharp border between eventrated portion and the remainder of the hemidiaphragm 4

Differential diagnosis

Possible consderations on plain film includes

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