Localized Eventration of Right Hemidiaphragm

September 14, 2005
Samer Alkhuja, MD

During the assessment of an 83-year-old man who had an infected arteriovenous graft, chest films showed a masslike density in the lower right hemithorax.

During the assessment of an 83-year-old man who had an infected arteriovenous graft, chest films showed a masslike density (arrows) in the lower right hemithorax. Because the patient was not a smoker, and because the lateral film showed that the density blended with the diaphragm, Dr Samer Alkhuja of Greenwich, Conn, suspected that the mass was not a tumor but, rather, an eventration-an abnormal elevation-of the right hemidiaphragm.

This proposed diagnosis was confirmed by a fluoroscopic study. No further investigations were carried out. The patient is currently undergoing hemodialysis for end-stage renal failure.

Weakness of the diaphragm with upward protrusion of the liver is the most common manifestation of localized eventration. It usually occurs on the anteromedial aspect of the right hemidiaphragm, through which protrudes a portion of the right lobe (the “anteromedial hump”) of the liver.1

REFERENCES:1. Juhl JH, Crummy AB, eds. Essentials of Radiologic Imaging. Philadelphia: JB Lippincott Co; 1993:1055-1056.