PARTIAL EVENTRATION OF THE RIGHT DIAPHRAGM (CONGENITAL DIAPHRAGMATIC HERNIATION OF THE LIVER)

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Abstract
Cases (6) of partial eventration of the right diaphragm are described, 5 in the anteromedian portion and one in the central portion. The herniation is due to a congenital aplasia of the diaphragmatic muscle in the affected area. The subjacent liver tissue is pressed into the developing diaphragmatic pouch and molded into an accessory lobe which arises as a hump from the superior surface of the liver. The herniated portion of liver rarely becomes strangulated and thus does not cause chest pain. The condition is usually asymptomatic and diagnosis is made from the typical radiologic findings, (an orange-sized, semicircular, smooth, homogeneous shadow on top of and merging into the diaphragmatic dome, usually situated anteriorly in the cardiophrenic angle, lagging behind on inspiration) and can be confirmed by means of a pneumoperitoneum which separates the liver from the diaphragmatic pouch. The condition can be differentiated from intrathoracic and subdiaphragmatic masses.

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