Elevation of the Diaphragm

Abstract

ELEVATION of the diaphragm may be temporary or permanent: it may be congenital or acquired: it may be symptomless—more often it is associated with such grave symptoms that surgical interference is imperative. The diagnostic significance of the elevated diaphragm seems very well appreciated by the roentgenologist, but his viewpoint does not seem to have been accepted generally, doubtless because he has not been convincing. I have in mind particularly the diagnostic significance of the elevation of the diaphragm as seen by X-rays in subphrenic abscess and diaphragmatic hernia; the former, at least, with an excessive mortality, the result of late diagnosis and still later operation. Temporary elevation of the diaphragm occurs in pneumonia, lung abscess, subphrenic abscess, liver abscess, diabetes, Banti's disease, during digestion, and normally at full expiration. Permanent elevation of the diaphragm may be seen in eventration, unoperated-upon diaphragmatic hernia, mediastinal tumor, aneurysm, chronic tuberc...