[Diaphragmatic paralysis and eventration].

Paralysis of the diaphragm normally heals in a matter of weeks, provided that it does not result from permanent damage to the phrenic nerve. The most frequent cause is traumatic, a consequence of birth or a postoperative complication, especially after cardiovascular surgery. The vital prognosis may involve respiratory insufficiency and consequent ventilation problems. But the situation has greatly changed as a result of the technical progress made in respiratory reanimation. When the necessary time is available, the indications of surgical plication are becoming rarer. Diaphragmatic eventration, on the other hand, involves rarefaction or the complete disappearance of the muscle fibres of the diaphragm. Over two thirds of such cases require surgical treatment. The eventration may result from an acquired affection leading to permanent destruction of the phrenic nerve. But it may also be associated with malformations, and in that event the prognosis is definitely severe.