All issues > Volume 41(4); 1998

Case Report

J Korean Pediatr Soc. 1998;41(4):553-557. Published online April 15, 1998.

A Case of Unilateral Diaphragmatic Paralysis with Brachial Plexus Palsy in the Neonate

Hae Joong HJ Yoon¹, Kyeung Ho KH Park¹, Sang Hee SH Kim¹, Kye Whan KW Seul¹, Gil Hyun GH Kim¹, Hak Soo HS Lee¹, Chang Young CY Lim²

¹Department of Pediatrics, General Ghil Hospital, Incheon, Korea
²Department of Thoracic Surgery, General Ghil Hospital, Incheon, Korea

Abstract

The diaphragm is especially important in sustaining minute ventilation in the neonate. Consequently, diaphragmatic paralysis is not tolerated well by the neonate and often results in prolonged respiratory failure. We experienced a case of unilateral diaphragmatic paralysis with the brachial plexus palsy in a male newborn infant who presented with apnea and cyanosis due to birth asphyxia. After endotracheal intubation, mechanical ventilaton was started. At two weeks after therapy, chest X-ray showed atelectasis and elevation of the right hemidiaphragm. The diagnosis of unilateral diaphragmatic paralysis was confirmed by real-time ultrasonography. At 4 weeks old, after several unsuccessful attempts at weaning from ventilatory support, right hemidiaphragm was plicated. On the second postoperative day, he could be weaned from ventiatory support without difficulty. He was doing well at follow-up 3 months later.

Keywords :Diaphragmatic paralysis, Brachial plexus palsy, Plication of diaphragm