Hernia and Eventration of the Diaphragm: Causes, Symptoms, and Surgical Interventions

Thu, 25 Jan 2024

Hernia and eventration of the diaphragm are two distinct conditions that affect the muscular partition that separates the chest cavity from the abdominal cavity, known as the diaphragm.

You need to understand that both of these conditions involve abnormalities of the diaphragmatic structure, leading to various complications. Understanding the causes, symptoms, and treatment approach is thus an essential one for an improved quality of life.

This article will explore everything you need to know about diaphragmatic hernias and eventrations and their treatment routes. For the expert advice you can consult Dr Arvind Kumar. 

Diaphragmatic hernia is a defect or hole in the diaphragm that allows the abdominal contents to move into the chest cavity. It may be present since birth or may develop later, usually following injury. Eventration is an extreme weakness of the diaphragm (present since birth) wherein the usually muscular diaphragm becomes papery thin and is unable to hold the abdominal organs in place.

The defect allows part of the organs from the belly (stomach, spleen and intestines) to go up into the chest cavity and press on the lungs and the heart, causing breathlessness and pain. Sometimes, the intestines may undergo torsion and become gangrene (dead) in the chest, a situation which may even be fatal.

What is Diaphragmatic Hernia and Eventration of the Diaphragm?

A diaphragmatic hernia occurs when there is a hole or weakness in the diaphragm, allowing organs from the abdominal cavity to protrude into the chest cavity. This can be congenital (present from birth) or acquired (developed later in life).

When distinguishing the different types of diaphragmatic hernia, the hiatal hernia is considered the most common. This is a situation where the part of the stomach protrudes through the diaphragm into the chest cavity.

Eventration of the diaphragm is a rare condition characterized by the abnormal elevation of a portion of the diaphragm. It is different from a hernia since, in this case, the diaphragm itself is weak or thin. This allows the abdominal contents to push upwards into the chest cavity.

What are the Causes of Diaphragmatic Hernia and Eventration of the Diaphragm?

When discussing the causes of these conditions, there are two routes it can go:

• Congenital – As the name suggests, this condition occurs during fetal development when the diaphragm doesn’t close fully. Such life-threatening conditions require immediate medical interventions after birth to fix the issue.
• Acquired – Sometimes, patients develop diaphragmatic hernias due to trauma, surgery, or muscle weakness. This could be due to age, obesity, or chronic coughing as well.

What are the Symptoms of Diaphragmatic Hernia and Eventration?

Albeit the slight differences in their manifestation, the symptoms of both diaphragmatic hernia and eventration are similar and include:

• Heartburn or acid reflux
• Chest pain or discomfort
• Difficulty swallowing
• Shortness of breath
• Nausea
• Vomiting
• Recurrent respiratory infections
• Asymmetrical chest movement

Based on these symptoms, the patient can consult a trained and experienced medical professional like Dr. Arvind Kumar to evaluate the condition further.

How are Diaphragmatic Hernia and Eventration Diagnosed?

The diagnosis is confirmed by X-ray and CT Scan of the chest. If you are experiencing these recurrent symptoms, the next thing that you need to do is prioritize consulting a medical professional.

Based on the symptoms, the specialist will start with a physical examination and analyze the medical history to assess possible complications.

Following that, blood tests and imaging tests are prescribed. Generally, the most accurate diagnosis is made via imaging tests like CT scans or X-rays.

How are Diaphragmatic Hernia and Eventration Treated?

Surgical intervention is often necessary to repair diaphragmatic hernias, mainly if they cause significant symptoms or complications.

Some of the most effective surgical interventions for diaphragmatic hernia include:

Laparoscopic surgery

This minimally invasive surgery is commonly used for repairing hiatal hernias. For this procedure, the surgeon starts by making small incisions in the abdomen and using video-assisted or robotic-assisted instruments and cameras to repair the hernia. It offers a quicker recovery period.

Open surgery

Open surgery is the ideal treatment route in cases where the diaphragmatic hernia has spread and progressed beyond normal. This involves making a larger incision in the abdomen or the chest to repair the hernia. This is a more serious procedure and requires a longer recovery period.

Tension-free hernia repair

This repair technique involves using synthetic mesh to reinforce the weakened diaphragm, reducing the risk of hernia recurrence.

In some cases, patients suffering from diaphragm eventration might have to undergo thoracoscopic surgery for hernia repair.

Why Choose Us?

Diaphragmatic hernias and eventrations are two distinct conditions that can affect the function of the diaphragm and, subsequently, a persons ability to breathe. The section of congenital hernias is generally repaired right after birth. However, if you are suffering from an acquired hernia in the diaphragm region, there are effective surgical interventions that are proven to offer practical and desired results that improve the patient’s quality of life.

Dr. Arvind Kumar, a leading chest surgeon in India with 40+ years of experience, has worked on thousands of patients with similar complaints. If you want to schedule an appointment or get a second opinion, contact us directly.

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