〽️DIAPHRAGMATIC EVENTRATION

🔹 typically affects only a segment of the hemidiaphragm

🔹 is due to incomplete muscularisation of the diaphragm with a thin membranous sheet replacing the normal diaphragmatic muscle. 

🔹 Over time this region stretches and on inspiration does not contract normally. 

🗣Sudden rupture can occur with increase in intra-abdominal pressure (e.g. coughing, straining during light anesthesia or extubation etc)

🔹True rupture (if it happens)  - Effects: 

🔹mass effect of the abdominal viscera-->direct compression of the heart, mediastinal shift 

🔹Compression of vena cava and pulmonary veins--> impairs venous return, decreased cardiac output. 

👉🏿So we should maintain adequate depth of anaesthesia 

👉🏿Avoid Nitrous oxide (expansion of intra-abdominal viscera can impair the circulation and respiration)

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Reference: Anaesthetic Management of an Adult Patient with Diaphragmatic Eventration

Azhar Rehman*, Zafar Ali Mirza, Saad Yousuf and Asma Abdus Salam, radiopaedia.org