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Diseases of the Diaphragm

The diaphragm, the main muscle involved in breathing, separates the thoracic and abdominal cavities. When a person inhales, it decreases pressure in the lungs and helps expand the rib cage. As with any organ or muscle, the diaphragm is subject to disorders and abnormalities, which come in many different forms and can stem from injury or illness.

Symptoms

Symptoms vary based on the disorder, but may include:

  • Discomfort or difficulty breathing
  • Pain in the chest, shoulder or abdominal area
  • Hypoxemia (a lack of oxygen in the blood)
  • Fewer breath sounds
  • Paralysis, in rare cases

Causes

Causes of diseases of the diaphragm vary, but they are usually a result of problems with the anatomy or the neurologic system, such as:

  • Congenital defects, which happen at birth and have no known cause
  • Acquired defects, which occur as the result of an injury, accident or surgery
  • Stroke
  • Muscular disorders, such as muscular dystrophy
  • Multiple sclerosis
  • Thyroid disorders
  • Lupus
  • Radiation therapy
  • Infection
  • Malnutrition
  • Trauma to the muscle or nerve going through the chest to the muscle

Diagnosis

The physician first will take the patient’s history and do a physical examination. Listening to a patient’s heart and breathing can often provide a great deal of information. Sometimes blood oxygen is measured through testing arterial blood gas.

Other tests may include:

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Treatment

We will work with the patient and family to make the most appropriate treatment decision, which may include one or more of the following therapies:

  • Medication
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  • Surgery. This may involve removing part of the diaphragm or abnormal tissue, folding the diaphragm, or repairing the muscle. Repair may involve the phrenic nerve, the only receiver of neurologic impulse in the diaphragm. Whenever possible, the surgeons will minimize incision size and invasiveness so that the patient’s hospital stay and recovery time are no longer than absolutely necessary.