Evaluation of pediatric diaphragmatic eventration using dynamic chest radiography: A case report

Introduction: Diagnosis of diaphragmatic disease using dynamic chest radiography (DCR), a novel imaging testing modality has been previously reported in adults; however, there have been no prior reports of its use in pediatric patients. Herein, we report the novel case of a 14-year-old girl diagnose...

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Main Authors: Takatoshi Abe, Kozo Nomura, Seisho Sakai, Rie Tanaka, Shuhei Minami, Hidenori Iwasaki, Yasuhiro Ikawa
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:Journal of Pediatric Surgery Case Reports
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Online Access:http://www.sciencedirect.com/science/article/pii/S221357662400160X
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author Takatoshi Abe
Kozo Nomura
Seisho Sakai
Rie Tanaka
Shuhei Minami
Hidenori Iwasaki
Yasuhiro Ikawa
author_facet Takatoshi Abe
Kozo Nomura
Seisho Sakai
Rie Tanaka
Shuhei Minami
Hidenori Iwasaki
Yasuhiro Ikawa
author_sort Takatoshi Abe
collection DOAJ
description Introduction: Diagnosis of diaphragmatic disease using dynamic chest radiography (DCR), a novel imaging testing modality has been previously reported in adults; however, there have been no prior reports of its use in pediatric patients. Herein, we report the novel case of a 14-year-old girl diagnosed with diaphragmatic eventration (DE) using DCR with extremely low-dose pulsed X-rays. Case series: A 14-year-old girl with pectus excavatum was referred to our hospital for surgery. Pre-operative chest radiography revealed that the right diaphragm was higher than the left however, this difference was judged to be within the normal range. Computed tomography (CT) revealed a Haller index of 3.00. Although the patient had no symptoms, she complained of an unsatisfactory appearance, which was considered an indication for surgery. The Nuss procedure was performed under artificial pneumothorax, and DE was not suspected. Six months after surgery, we performed DCR instead of chest radiographs to evaluate the position of the bar and the patient's respiratory status. Utilizing the captured images, we further measured and analyzed the diaphragm movement. DCR revealed a clear impairment of diaphragmic movement on the affected side, and the patient was subsequently diagnosed with DE. However, as she was asymptomatic, we decided to follow up conservatively. Conclusion: This is the first report of DCR in a pediatric patient. DCR appears to be a useful tool for the diagnosis of diaphragmatic eventration in children.
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spelling doaj-art-68e32e4f874a41308a52278a3b873a9b2025-08-20T02:37:45ZengElsevierJournal of Pediatric Surgery Case Reports2213-57662025-01-0111210293210.1016/j.epsc.2024.102932Evaluation of pediatric diaphragmatic eventration using dynamic chest radiography: A case reportTakatoshi Abe0Kozo Nomura1Seisho Sakai2Rie Tanaka3Shuhei Minami4Hidenori Iwasaki5Yasuhiro Ikawa6Department of Pediatric Surgery, Kanazawa University Hospital, Ishikawa, Japan; Corresponding author. Department of Pediatric Surgery, Kanazawa University Hospital, Takaramachi 13-1, Kanazawa, Ishikawa, Japan.Department of Pediatric Surgery, Kanazawa University Hospital, Ishikawa, JapanDepartment of Pediatric Surgery, Kanazawa University Hospital, Ishikawa, JapanCollege of Medical, Pharmaceutical & Health Sciences, Kanazawa University, Ishikawa, JapanDivision of Radiological Technology, Kanazawa University Hospital, Ishikawa, JapanDepartment of Pediatrics, Graduate School of Medical Science, Kanazawa University, Ishikawa, JapanDepartment of Pediatrics, Kanazawa Medical University, Ishikawa, JapanIntroduction: Diagnosis of diaphragmatic disease using dynamic chest radiography (DCR), a novel imaging testing modality has been previously reported in adults; however, there have been no prior reports of its use in pediatric patients. Herein, we report the novel case of a 14-year-old girl diagnosed with diaphragmatic eventration (DE) using DCR with extremely low-dose pulsed X-rays. Case series: A 14-year-old girl with pectus excavatum was referred to our hospital for surgery. Pre-operative chest radiography revealed that the right diaphragm was higher than the left however, this difference was judged to be within the normal range. Computed tomography (CT) revealed a Haller index of 3.00. Although the patient had no symptoms, she complained of an unsatisfactory appearance, which was considered an indication for surgery. The Nuss procedure was performed under artificial pneumothorax, and DE was not suspected. Six months after surgery, we performed DCR instead of chest radiographs to evaluate the position of the bar and the patient's respiratory status. Utilizing the captured images, we further measured and analyzed the diaphragm movement. DCR revealed a clear impairment of diaphragmic movement on the affected side, and the patient was subsequently diagnosed with DE. However, as she was asymptomatic, we decided to follow up conservatively. Conclusion: This is the first report of DCR in a pediatric patient. DCR appears to be a useful tool for the diagnosis of diaphragmatic eventration in children.http://www.sciencedirect.com/science/article/pii/S221357662400160XDynamic chest radiographyRadiation exposureDiaphragm eventrationCase report
spellingShingle Takatoshi Abe
Kozo Nomura
Seisho Sakai
Rie Tanaka
Shuhei Minami
Hidenori Iwasaki
Yasuhiro Ikawa
Evaluation of pediatric diaphragmatic eventration using dynamic chest radiography: A case report
Journal of Pediatric Surgery Case Reports
Dynamic chest radiography
Radiation exposure
Diaphragm eventration
Case report
title Evaluation of pediatric diaphragmatic eventration using dynamic chest radiography: A case report
title_full Evaluation of pediatric diaphragmatic eventration using dynamic chest radiography: A case report
title_fullStr Evaluation of pediatric diaphragmatic eventration using dynamic chest radiography: A case report
title_full_unstemmed Evaluation of pediatric diaphragmatic eventration using dynamic chest radiography: A case report
title_short Evaluation of pediatric diaphragmatic eventration using dynamic chest radiography: A case report
title_sort evaluation of pediatric diaphragmatic eventration using dynamic chest radiography a case report
topic Dynamic chest radiography
Radiation exposure
Diaphragm eventration
Case report
url http://www.sciencedirect.com/science/article/pii/S221357662400160X
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