OV17 LAPAROSCOPIC REPAIR OF A DIAPHRAGMATIC EVENTRATION

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Abstract Aim Diaphragmatic eventration (DE) is a rare condition affecting 0,05% of general population. DE is the abnormal elevation of a portion of a entire hemidiaphragm due to a lack of muscle or nerve function. It can be congenital or acquired. The most common cause of DE is cardiac surgery. It can be asymptomatic or present mild symptoms as dispnea, palpitations, pneumonia. Material and Methods 61 years old male with medical history of arterial hypertension, DMII, Hyperlipidemia. He had a motor vehicle accident with 6 to 9 left ribs fractures. One month later complained of dyspnea with shortness of air to normal activity. Rx: elevation of left diaphragm. CT scan: elevation of left diaphragm without rupture, passive atelectasis of inferior left lobe of the lung. He initiated respiratory physiotherapy without improvement of the symptoms. 4 months after the accident, we had a stroke with right hemiparesis. This situation produced worsening of the dyspnea. Physiotherapy was reinforced with recuperation of the hemiparesis, but poor improvement of the dyspnea. 10 months after the accident, surgery was indicated for plication of the diaphragm to improve the respiratory function. Results The video shows the radiological exams and the surgery performed. Laparoscopic diaphragmatic plication with a reinforcement with a coated mesh (Uncoated monofilament polypropylene mesh on the anterior side with an absorbable hydrogel barrier). He was discharge 2 days after surgery. The patient improved significantly in his respiratory symptoms an imaging exams. Conclusions Posttraumatic DE must be treated surgically with low morbidity and good functional results.