Diaphragm Disorders Differential Diagnoses

  • Author: Ryland P Byrd Jr, MD; Chief Editor: Zab Mosenifar, MD   more...
 
Updated: Apr 23, 2012
 
 

Differential Diagnoses

  • Decreased pulmonary or abdominal compliance
  • Pleural adhesions
Proceed to Workup
 
 
Contributor Information and Disclosures
Author

Ryland P Byrd Jr, MD  Professor, Department of Internal Medicine, Division of Pulmonary Medicine and Critical Care Medicine, Program Director of Pulmonary Diseases and Critical Care Medicine Fellowship, East Tennessee State University, James H Quillen College of Medicine; Medical Director of Respiratory Therapy, James H Quillen Veterans Affairs Medical Center

Ryland P Byrd Jr, MD is a member of the following medical societies: American College of Chest Physicians and American Thoracic Society

Disclosure: Nothing to disclose.

Specialty Editor Board

Ryland P Byrd Jr, MD  Professor, Department of Internal Medicine, Division of Pulmonary Medicine and Critical Care Medicine, Program Director of Pulmonary Diseases and Critical Care Medicine Fellowship, East Tennessee State University, James H Quillen College of Medicine; Medical Director of Respiratory Therapy, James H Quillen Veterans Affairs Medical Center

Ryland P Byrd Jr, MD is a member of the following medical societies: American College of Chest Physicians and American Thoracic Society

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Om Prakash Sharma, MD, FRCP, FCCP, DTM&H  Professor, Department of Medicine, Division of Pulmonary and Critical Care Medicine, University of Southern California Keck School of Medicine

Om Prakash Sharma, MD, FRCP, FCCP, DTM&H is a member of the following medical societies: American Academy of Allergy Asthma and Immunology, American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, American Osler Society, American Thoracic Society, New York Academy of Medicine, and Royal Society of Medicine

Disclosure: Nothing to disclose.

Timothy D Rice, MD  Associate Professor, Departments of Internal Medicine and Pediatrics and Adolescent Medicine, St Louis University School of Medicine

Timothy D Rice, MD is a member of the following medical societies: American Academy of Pediatrics and American College of Physicians

Disclosure: Nothing to disclose.

Chief Editor

Zab Mosenifar, MD  Director, Division of Pulmonary and Critical Care Medicine, Director, Women's Guild Pulmonary Disease Institute, Professor and Executive Vice Chair, Department of Medicine, Cedars Sinai Medical Center, University of California, Los Angeles, David Geffen School of Medicine

Zab Mosenifar, MD is a member of the following medical societies: American College of Chest Physicians, American College of Physicians, American Federation for Medical Research, and American Thoracic Society

Disclosure: Nothing to disclose.

Additional Contributors

The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors Anne T Saladyga, MD, Jason M Johnson, DO, Sidney R Steinberg, MD, FACS, and Abhijit A Raval, MD,to the development and writing of this article.

References

  1. Rochester DF. The diaphragm: contractile properties and fatigue. J Clin Invest. May 1985;75(5):1397-402. [Medline].

  2. Wiseman NE, MacPherson RI. "Acquired" congenital diaphragmatic hernia. J Pediatr Surg. Oct 1977;12(5):657-65. [Medline].

  3. Shah R, Sabanathan S, Mearns AJ, Choudhury AK. Traumatic rupture of diaphragm. Ann Thorac Surg. Nov 1995;60(5):1444-9. [Medline].

  4. Sharma OP. Traumatic diaphragmatic rupture: not an uncommon entity--personal experience with collective review of the 1980's. J Trauma. May 1989;29(5):678-82. [Medline].

  5. Keller RL, Tacy TA, Hendricks-Munoz K, et al. Congenital Diaphragmatic Hernia: Endothelin-1, Pulmonary Hypertension and Disease Severity. Am J Respir Crit Care Med. Apr 22 2010;[Medline].

  6. Grmoljez PF, Lewis JE Jr. Congenital diaphragmatic hernia: Bochdalek type. Am J Surg. Dec 1976;132(6):744-6. [Medline].

  7. Rees JR, Redo SF, Tanner DW. Bochdalek's hernia. A review of twenty-one cases. Am J Surg. Mar 1975;129(3):259-61. [Medline].

  8. Greer JJ, Babiuk RP, Thebaud B. Etiology of congenital diaphragmatic hernia: the retinoid hypothesis. Pediatr Res. May 2003;53(5):726-30. [Medline].

  9. Kumar N, Folger WN, Bolton CF. Dyspnea as the predominant manifestation of bilateral phrenic neuropathy. Mayo Clin Proc. Dec 2004;79(12):1563-5. [Medline].

  10. Zifko U, Auinger M, Albrecht G, et al. Phrenic neuropathy in chronic renal failure. Thorax. Jul 1995;50(7):793-4. [Medline].

  11. Efthimiou J, Butler J, Woodham C, Benson MK, Westaby S. Diaphragm paralysis following cardiac surgery: role of phrenic nerve cold injury. Ann Thorac Surg. Oct 1991;52(4):1005-8. [Medline].

  12. Brander PE, Jarvinen V, Lohela P, Salmi T. Bilateral diaphragmatic weakness: a late complication of radiotherapy. Thorax. Sep 1997;52(9):829-31. [Medline].

  13. Murciano D, Rigaud D, Pingleton S, Armengaud MH, Melchior JC, Aubier M. Diaphragmatic function in severely malnourished patients with anorexia nervosa. Effects of renutrition. Am J Respir Crit Care Med. Dec 1994;150(6 Pt 1):1569-74. [Medline].

  14. Lemons VR, Wagner FC Jr. Respiratory complications after cervical spinal cord injury. Spine. Oct 15 1994;19(20):2315-20. [Medline].

  15. Iverson LI, Mittal A, Dugan DJ, Samson PC. Injuries to the phrenic nerve resulting in diaphragmatic paralysis with special reference to stretch trauma. Am J Surg. Aug 1976;132(2):263-9. [Medline].

  16. van Vugt AB, Schoots FJ. Acute diaphragmatic rupture due to blunt trauma: a retrospective analysis. J Trauma. May 1989;29(5):683-6. [Medline].

  17. Heffner JE. Diaphragmatic paralysis following chiropractic manipulation of the cervical spine. Arch Intern Med. Mar 1985;145(3):562-4. [Medline].

  18. Davis J, Goldman M, Loh L, Casson M. Diaphragm function and alveolar hypoventilation. Q J Med. Jan 1976;45(177):87-100. [Medline].

  19. Gierada DS, Slone RM, Fleishman MJ. Imaging evaluation of the diaphragm. Chest Surg Clin N Am. May 1998;8(2):237-80. [Medline].

  20. Summerhill EM, El-Sameed YA, Glidden TJ, McCool FD. Monitoring recovery from diaphragm paralysis with ultrasound. Chest. Mar 2008;133(3):737-43. [Medline].

  21. Bellemare F, Bigland-Ritchie B. Assessment of human diaphragm strength and activation using phrenic nerve stimulation. Respir Physiol. Dec 1984;58(3):263-77. [Medline].

  22. Hill NS. Noninvasive ventilation. Does it work, for whom, and how?. Am Rev Respir Dis. Apr 1993;147(4):1050-5. [Medline].

  23. DiMarco AF, Onders RP, Kowalski KE, Miller ME, Ferek S, Mortimer JT. Phrenic nerve pacing in a tetraplegic patient via intramuscular diaphragm electrodes. Am J Respir Crit Care Med. Dec 15 2002;166(12 Pt 1):1604-6. [Medline].

  24. Glenn WW. The treatment of respiratory paralysis by diaphragm pacing. Ann Thorac Surg. Aug 1980;30(2):106-9. [Medline].

  25. Glenn WW, Hogan JF, Loke JS, Ciesielski TE, Phelps ML, Rowedder R. Ventilatory support by pacing of the conditioned diaphragm in quadriplegia. N Engl J Med. May 3 1984;310(18):1150-5. [Medline].

  26. Ciccolella DE, Daly BD, Celli BR. Improved diaphragmatic function after surgical plication for unilateral diaphragmatic paralysis. Am Rev Respir Dis. Sep 1992;146(3):797-9. [Medline].

  27. Freeman RK, Wozniak TC, Fitzgerald EB. Functional and physiologic results of video-assisted thoracoscopic diaphragm plication in adult patients with unilateral diaphragm paralysis. Ann Thorac Surg. May 2006;81(5):1853-7; discussion 1857. [Medline].

  28. Baum GL, Crapo JD, Celli BR, eds. Textbook of Pulmonary Diseases. 6th ed. Boston, Mass: Little Brown & Company; 1995.

  29. Murray JF, Nadel JA, eds. Textbook of Respiratory Medicine. Philadelphia, Pa: WB Saunders; 1997.

 
Previous
Next
 
Radiograph of a man who fell 45 ft from scaffolding, through plate glass windows, and onto the ground. Intraoperatively, he had a completely avulsed diaphragm on the left side. The patient subsequently recovered after a 45-day hospital course of treatment.
 
 
 
All material on this website is protected by copyright, Copyright © 1994-2012 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.