Diaphragmatic relaxation

Diaphragmatic relaxation

    * Introduction
    * Signs and symptoms
    * Diagnosis
    * Treatment
Diaphragmatic relaxation is a frequently encountered pathology because it is not generally oligosimptomatica. The development of modern technology has induced a significant contribution to the diagnosis and treatment of disease. Diaphragmatic relaxation or diaphragmatic eventration, the diaphragm ascended idiopathic diaphragmatic failure, neurogenic diaphragmatic aplasia is a rare congenital anomaly in which a portion or an entire hemidiafragm is permenent ascended, his mentinundu continuity rib inserts and pleural and peritoneal serous two daughters; diaphragmatic eventration in skeletal muscle fiber number is much lower.
Unlike diaphragmatic hernia in the diaphragm eventration is continuous. Although the disease has been recognized since 1774, diaphragmatic eventration term was introduced only in 1829. Over a century of first surgery for this disease. Principles of surgery then apply today.
Diaphragmatic relaxation can be caused by paralysis and diaphragmatic-acquired disease, usually caused by phrenic nerve pathology, the diaphragm is atrophic but the normal number of muscle fibers. Although various pathogenic, and diaphragmatic eventration diaphragmatic paralysis usually produce the same physiological changes and are similar radiological and imaging.
Real incidence of diaphragmatic eventrations is not known. Diaphragmatic eventration is usually unilateral and incomplete, defending the right anteromedial; Full eventration occurs more frequently in males on the left side.
Pathogenesis and causes:
Diaphragmatic eventration true is the result of a congenital defect of diaphragm muscle. Faults caused by incomplete migration of somitele mioblastilor cervical pleuro-peritoneal membrane during the 4th week of embryonic development. Histologically eventrat shows dezorgabizarea and diaphragm skeletal muscle fiber degeneration with modifications fibroelastice and leukocyte infiltration. Diaphragmatic eventration may be associated other congenital malformations: hypoplasia of the aorta, transposition of the abdominal organs, crack the hard palate, intra-abdominal testes, may be associated with cytomegalovirus infection or prenatal maternal exposure to thiopental. The anatomically eventrations diaphragm can be unilateral or total. Limited localized form can be described as diaphragmatic diverticulum.
Eventration diaphragmatic paralysis is due to problems determining the phrenic nerve: -Trauma: obstetrical accidents, cervical or thoracic spinal cord injury -Neck surgery: thyroid, radical neck dissection, jugular or subclavian vein Tubular -Infections: diphtheria, tuberculosis, luess, typhoid, polio, herpes zoster, influenza, rubella -Cancer: metastatic lung cancer with mediastinal lymph nodes, gun = dead mediastinal malignant lymphoma -Diverse miotoxica dystrophy, neurogenic amyotrophy, pericarditis, lead poisoning Undiagnosed viral infection, probably idiopathic.