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     Journal of Indian Association of Pediatric Surgeons
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Table of Contents   
IMAGES IN CLINICAL PRACTICE
Year : 2020  |  Volume : 25  |  Issue : 5  |  Page : 326-327
 

Repair of recurrent eventration of the diaphragm by latissimus dorsi flap: A novel technique


1 Department of Paediatric Surgery, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
2 Department of Paediatric Surgery, Manipal Hospitals, Bengaluru, Karnataka, India
3 Department of Plastic Surgery, Manipal Hospitals, Bengaluru, Karnataka, India

Date of Submission05-May-2020
Date of Decision07-Jun-2020
Date of Acceptance20-Jun-2020
Date of Web Publication1-Sep-2020

Correspondence Address:
Dr. Chittur Narendra Radhakrishnan
Department of Paediatric Surgery, Manipal Hospitals, Bengaluru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jiaps.JIAPS_140_20

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How to cite this article:
Radhakrishna V, Radhakrishnan CN, Nagireddy SR, Rao Anantheswar YN. Repair of recurrent eventration of the diaphragm by latissimus dorsi flap: A novel technique. J Indian Assoc Pediatr Surg 2020;25:326-7

How to cite this URL:
Radhakrishna V, Radhakrishnan CN, Nagireddy SR, Rao Anantheswar YN. Repair of recurrent eventration of the diaphragm by latissimus dorsi flap: A novel technique. J Indian Assoc Pediatr Surg [serial online] 2020 [cited 2020 Sep 26];25:326-7. Available from: http://www.jiaps.com/text.asp?2020/25/5/326/294000




An 11-month-old female infant with a past history of surgery for left-sided eventration of the diaphragm presented with recurrent lower respiratory tract infections. Plain X-ray chest showed a recurrence of eventration [Figure 1]a. An upper gastrointestinal contrast study revealed the stomach and splenic flexure occupying the eventration and no evidence of gastro-esophageal reflux [Figure 1]b. Intraoperatively, a left-sided latissimus dorsi flap was identified, dissected, and safeguarded [Figure 2]a. Thoracotomy was done in the 5th intercostal space. The eventrated diaphragm was plicated [Figure 2]b and reinforced with left latissimus dorsi flap [Figure 2]c. The follow-up was uneventful. She was thriving well at 2 years' follow-up. To the best of our knowledge, this is the first case where latissimus dorsi flap has been used as dynamic recruitment between the thoracic and the abdominal cavity for managing recurrent diaphragmatic eventration.
Figure 1: (a) The plain X-ray chest showing an elevated left dome of the diaphragm with a shift of the mediastinum to the right and hyperinflated right lung with transmediastinal herniation. (b) An upper gastrointestinal contrast study showing left-sided eventration of the diaphragm with splenic flexure occupying the eventration

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Figure 2: (a) A left-sided latissimus dorsi flap was identified, dissected, and safeguarded. (b) The plicated left-sided diaphragmatic eventration. (c) The left latissimus dorsi flap reinforced to the plicated diaphragm

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Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form, the legal guardian has given his consent for images and other clinical information to be reported in the journal. The guardian understands that names and initials will not be published and due efforts will be made to conceal patient identity, but anonymity cannot be guaranteed.




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  [Figure 1], [Figure 2]



 

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