Hemidiaphragm dysfunction due to megacolon: functional recovery after colectomy.
We describe an uncommon case of hemidiaphragm dysfunction in a man with megacolon. The patient complained of exertional dyspnoea associated with a restrictive ventilatory impairment, a reduction in respiratory muscle force, and a left hemidiaphragm elevation on roentgenogram. During maximal inspiratory manoeuvre, the electromyograph (EMG) showed an abnormal pattern in the time of recruitment of the left hemidiaphragm, associated with a rapid decline in force. After abdominal surgery (total colectomy) a significant improvement in lung volumes was observed, together with a resolution of dyspnoea. Respiratory muscle force returned to normal values with a normal EMG, whilst the elevation of the left hemidiaphragm at radiography was still present, though to a lesser extent.
Nava
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Division of Pneumology, Fondazione Clinica del Lavoro, IRCCS, Milano, Italy.
Schiavoni
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PG
D003082:Colectomy; D003964:Diaphragm / Q000503:physiopathology; D004417:Dyspnea / Q000209:etiology / Q000517:prevention & control; D004576:Electromyography; D006801:Humans; D008297:Male; D008531:Megacolon / Q000150:complications* / Q000601:surgery; D008875:Middle Aged; D012129:Respiratory Function Tests; D012132:Respiratory Muscles / Q000503:physiopathology; D012133:Respiratory Paralysis / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control