CTICasesLeft Hemidiaphragm Eventration Treated with Plication
Imaging findings
Chest radiograph demonstrates marked elevation of the left hemidiaphragm. CT sagittal reformats show the anterior hemidiaphragm progressively thinning and folding back on itself in a hairpin turn configuration, with the posterior crus remaining normal in thickness. The diaphragm is present but attenuated anteriorly, curling upward. Post-plication radiograph shows improved hemidiaphragm position.
Key takeaways
Diaphragmatic eventration is a congenital or acquired weakness of the hemidiaphragm producing marked elevation. CT sagittal and coronal reformats are key for distinguishing eventration from hernia by demonstrating a thin but intact diaphragmatic membrane that folds on itself. The posterior crus is normal in thickness in eventration, unlike in paralysis. The mushroom or hairpin fold of the diaphragm can mimic hernia radiographically.
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