成人期の先天性横隔膜弛緩症

Thoracoscopic Plication for Congenital Diaphragmatic Eventration in an Adult

横隔膜弛緩症は先天性と後天性があり，先天性は胎生期の発育段階での横隔膜筋線維の消失や筋性発達不全，後天性は分娩外傷や縦隔腫瘍など神経障害に起因するとされる．われわれは，乳児期に肺炎を契機に診断された横隔膜弛緩症に対し，40年以上経過後に胸腔鏡下横隔膜縫縮術を施行した1例を経験したので報告する．

Thoracoscopic plication for congenital diaphragmatic eventration in an adult. Diaphragmatic eventration is known to be abnormal elevation of diaphragm and congenital causes are due to abnormal diaphragm muscle development. Here we report surgical treatment of congenital diaphragmatic eventration.

A 45-year-old woman who complained of cough was admitted to our hospital. She had history of cough and was diagnosed as diaphragmatic eventration in childhood. Chest X-ray showed elevated left hemidiaphragm with a bowel gas underneath. Under the diagnosis of congenital eventration of left hemidiaphragm, plication of the left diaphragm by video-assisted thoracoscopic surgery （VATS） was performed. One month after surgery, severe cough disappeared completely.