Idiopathic diaphragmatic paralysis

Riley, Edgar Alsop

doi:10.1016/0002-9343(62)90130-4

Cited by 70 publications

(28 citation statements)

References 31 publications

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“…Diaphragmatic paralysis leading to respiratory failure is usually caused by compression, a tumor, or surgical complications to phrenic nerves (3)(4)(5). Commonly, the respiration of patients with diaphragmatic paralysis exhibits a paradoxical movement of the abdomen: the abdominal wall retracts during inspiration and protrudes during the expiration phase (6) (Fig.…”

Section: Introductionmentioning

confidence: 99%

Diaphragmatic Paralysis in a Patient with Spinal Cord Infarction

et al. 2009

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Section: Introductionmentioning

confidence: 99%

Diaphragmatic Paralysis in a Patient with Spinal Cord Infarction

et al. 2009

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“…It is presumed that acquired eventration of the diaphragm is induced by either an idiopathic atrophic change in the diaphragm or by secondary atrophic changes caused by various factors related to neurological dysfunction [3]. The most typical symptom is respiratory insufficiency.…”

Section: Discussionmentioning

confidence: 99%

Barrett's adenocarcinoma associated with acquired eventration of the diaphragm

et al. 1998

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our knowledge, no case of Barrett's adenocarcinoma associated with eventration of the diaphragm has previously been reported. We report here such a rare case and discuss the association of Barrett's esophagus and eventration of the diaphragm. Case reportA 71-year-old woman initially presented with epigastralgia and dysphagia in early May, 1997. On July 9, she was referred to our Department of Surgery at the Ryukyus University Hospital to undergo thorough examination and treatment after presenting at a local hospital with worsening of these symptoms.She had no contributory family history. Her past medical history revealed that she had previously undergone an appendectomy at 38 years of age, and that elevation of the left diaphragm was detected during a regular medical checkup at 44 years of age. However, she had not complained of any symptoms since then.On physical examination at admission, her respiratory sounds were diminished over the lower left lung field, but otherwise no abnormalities were observed. Chest X-ray revealed elevated left diaphragm, while the heart had shifted toward the right (Fig. 1). Esophagography showed dilatation of the lower esophagus and partial obstruction by a mass with a ragged surface in the lower esophagus. Barium meal stagnated in the esophagus and streamed only slightly into the stomach (Fig. 2). Computed tomography (CT) and magnetic resonance imaging (MRI) revealed increased wall thickness of the abdominal esophagus through the cardia of the stomach and elevated thin diaphragm (Fig. 3). Endoscopic examination showed a large cauliflower-type tumor in the distal esophagus approximately 36 cm away from the incisors. The tumor occupied most of the esophageal lumen and the endoscopic fiber could not get through to the anal side of the tumor. Abstract:We report a rare case of Barrett's adenocarcinoma associated with acquired eventration of the diaphragm in a 71-year-old woman. She initially developed dysphagia and epigastric discomfort in May, 1997. On July 9, she was referred to our Department of Surgery at the Ryukyus University Hospital for thorough examination and treatment. Esophageal adenocarcinoma and eventration of the diaphragm were revealed by exhaustive examinations, including chest X-ray, computed tomography, and magnetic resonance imaging, and proximal gastrectomy with reconstruction of jejunal interposition was performed, on August 8. Histologically, the tumor revealed that the adenocarcinoma arose from short-segment Barrett's esophagus (SSBE). It thus appears that eventration of the diaphragm may induce SSBE and Barrett's adenocarcinoma. We therefore recommend that periodic examinations of the esophagus and stomach be performed in patients with eventration of the diaphragm. Barrett's adenocarcinoma associated with acquired eventration of the diaphragm is reported. Patients with eventration of the diaphragm should undergo periodic examinations of the esophagus and stomach.

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“…Embora determinados tipos de toxinas como a diftérica e a anti-toxma tetânica possam deterrninar este tipo de coraplicação 15 , até a presente data a paralisia diafragmática não havia sido observada no envenenamento loxoscélieo, que, reconhecidamente, não possui ação neurotóxica sistêmica VA 7 , 8 , em que pese o relato de um caso de mielite necronizante aguda íatal em paciente vítima de envenenamento por este tipo de aranha n. A ausência de sinais de paralisia frênica em radiografias anteriores e o seu desaparecimento em estudos radiológicos posteriores permitiu associá-la à toxicidade do veneno loxoscélieo ou a outras manifestações sistêmicas produzidas por ele.…”

Section: Discussionunclassified

Paralisia diafragmática unilateral reversível associada a envenenamento loxoscélico sistêmico

Rezende

Amaral

Oliveira

1986

Rev. Inst. Med. trop. S. Paulo

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Relata-se o caso de um paciente vítima de envenenamento loxoscélico associado a paralisia diafragmática direita reversível. O diagnóstico de envenenamento loxoscélico baseou-se nas informações prestadas pelo paciente de que havia encontrado uma aranha marrom em sua cama no dia seguinte à picada e no quadro clínico típico deste tipo de envenenamento: lesão cutânea necrótica acompanhada de erupção escarlatiniforme e comprometimento sistêmico sob a forma de insuficiência renal aguda, distúrbios da coagulação sangüínea, hemólise intravascular e hemoglobinúria. Estas alterações regrediram completamente com o tratamento conservador. O diagnóstico da paralisia diafragmática baseou-se na elevação da hemicúpula diafragmática direita na radiografia de tórax em inspiração força-da e em sua completa imobilidade no exame radioscópico. A paralisia frênica não existia na radiografia realizada previamente ao acidente e desapareceu completamente trinta dias após o mesmo, o que permitiu associá-la à toxocidade do veneno loxoscélico ou a outras manifestações sistêmicas produzidas por ele. UNITERMOS: Envenenamento loxoscélico; Loxosceles sp -Paralisia diafragmática humana. INTRODUÇÃOOs acidentes produzidos por aranhas venosas do gênero Loxosceles podem determinar, em decorrência das ações proteolíticas, hemolíticas e coagulantes do veneno loxoscélico, necrose tecidual grave, hemólise intravascular, hemoglobinúria, coagulação intravascular disseminada, lesão hepática e insuficiência renal aguda 7,8,io,i3. Estas complicações podem colocar em risco a vida da vítima destes envenenamentos. Em nosso meio são raras as publicações referentes a este tipo de envenenamento 5,6,11, Neste trabalho relatá-se o caso de um paciente vítima de acidente aracnídico loxoscéli-co que, além do comprometimento cutâneo e visceral graves, apresentou paralisia diafragmá-tica unilateral reversível. Esta complicação associada ao envenenamento loxoscélico não foi ainda relatada na literatura.RELATO DO CASO J.N.S., 28 anos, masculino, leucoderma, comerciante, foi picado no antebraço esquerdo por uma aranha marrom no dia 22 de março

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Idiopathic diaphragmatic paralysis

Cited by 70 publications

References 31 publications

Diaphragmatic Paralysis in a Patient with Spinal Cord Infarction

Diaphragmatic Paralysis in a Patient with Spinal Cord Infarction

Barrett's adenocarcinoma associated with acquired eventration of the diaphragm

Paralisia diafragmática unilateral reversível associada a envenenamento loxoscélico sistêmico

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