Diaphragmatic Elevation

What Is Diaphragmatic Elevation?

The diaphragm is located between the thoracic and abdominal cavities and, among others, separates the lungs from essential organs. It is the most important respiratory muscle and ensures smooth inhalation and exhalation. During inhalation, it tenses and changes its position by sinking downward, creating a negative pressure in the thoracic cavity that fills the lungs with air. On exhalation, the diaphragm relaxes and returns to its original upward position, forcing air out of the lungs.

On the right side, the diaphragm is positioned above the liver and, therefore, slightly higher, even in a healthy state, than on the left side, where it is located above the spleen. However, if the diaphragm moves excessively upward, it is referred to as a diaphragmatic elevation. Depending on the cause, such a diaphragmatic elevation can be diagnosed on the right or left side but also bilateral.

Causes and Symptoms of Diaphragmatic Elevation

There are numerous causes of an elevated diaphragm, but the most common are diaphragmatic paralysis, obesity, an enlarged liver or spleen, and viral diseases. Diseases of the lungs, such as pneumonia or congenital malformations, can also be causative. In addition, pregnancy often causes the diaphragm to move upward due to the enlarged uterus.

If the diaphragm is located too high, its function is restricted and constricts the lungs, causing breathing difficulties. In more severe cases, this becomes noticeable as shortness of breath.

How Is Diaphragmatic Elevation Diagnosed?

An X-ray primarily diagnoses the chest on which the doctor can see the downward displaced borders of the diaphragm. Furthermore, laboratory diagnostic tests and lung function tests can provide information.

Is Diaphragmatic Elevation Dangerous?

Diaphragmatic elevation causes restricted breathing and often leads to shortness of breath. In addition, permanent untreated diaphragmatic elevation can lead to inflammation of the diaphragm, leading to more drastic consequences. Therefore, this condition should be taken seriously, and a specialist should be consulted at an early stage.

Diaphragmatic Elevation Therapy

Often, diaphragmatic elevation is a phenomenon of another disease. Therefore, therapy should always focus on treating the underlying cause. For example, during pregnancy, symptom relief is needed since the uterus shrinks back to its original size after birth. If, for example, fatty liver or obesity are causative factors, weight loss and a healthier lifestyle are the first priority. In some cases, however, conservative therapy is insufficient, and surgical repair of the diaphragmatic condition is unavoidable.

Conservative Treatment

Conservative treatment refers to non-surgical measures that lead to the patient's recovery. For example, many causes of diaphragmatic elevation can be corrected without surgery.

These include the aforementioned diaphragmatic elevation during pregnancy, which resolves itself after delivery. In addition, patients can do specific breathing exercises to relieve the symptoms of shortness of breath.

If pneumonia is the cause, antibiotics and anti-inflammatory drugs are usually administered. This will usually also return the diaphragm to its normal position.

As mentioned above, fatty liver and obesity (abdominal obesity) are common precursors to diaphragmatic elevation. Therefore, these patients should work on drastic fat loss through exercise and healthier eating before the diaphragm becomes the focus of treatment.

Diaphragm Surgery

Surgical treatment is an option, especially for diaphragmatic paralysis. The diaphragm is innervated from both sides by one phrenic nerve, susceptible to injury and infection. Damage to the phrenic nerve can occur mainly during surgery, as it takes a long and complex course and can therefore be overlooked. In such cases, unilateral diaphragmatic paralysis usually results (more common). Infections, such as Lyme disease or viral infections, can also damage the phrenic nerves.

A paralyzed diaphragm can no longer descend adequately, causing an elevation into the chest, especially during inhalation, which impairs breathing. Although, due to gravity, this occurs especially when lying down, standing upright can relieve symptoms a little.

Surgery aims to tighten the flaccid diaphragm (usually on one side) with sutures so that it no longer moves into the chest during inhalation.

This results in improved breathing capacity, and patients can inhale again. Before surgery, any concomitant diseases leading to worsening breathing problems should be identified and treated.

Surgery can be carried out either open or minimally invasive. The choice of the best possible method depends on the patient's individual health situation and severity of the diaphragmatic paralysis, and, last but not least, the preference of the treating physician.

Aftercare and Prognosis

Patients need to stay in the hospital for about a week after surgery and adjust to physiotherapy exercises. During the postoperative stay, diagnostic tests and imaging procedures (chest X-ray) are done. Then, one month after surgery, patients visit the physician for follow-up.

Studies proved that the surgical ripping of a paralyzed diaphragm leads to a significant improvement in breathing capacity, even in the long term. Patients suffer less shortness of breath postoperative, and their life expectancy improves.

Which Doctors and Clinics Specialize in Diaphragmatic Elevation?

Every patient who needs a doctor wants the best medical care. Therefore, the patient is wondering where to find the best clinic. As this question cannot be answered objectively, and a reliable doctor would never claim to be the best one, we can only rely on a doctor's experience.

We will help you find an expert for your condition. All listed doctors and clinics have been reviewed by us for their outstanding specialization in diaphragmatic elevation and are awaiting your inquiry or treatment request.