Published online Aug 6, 2024. doi: 10.12998/wjcc.v12.i22.5253
Revised: May 23, 2024
Accepted: June 4, 2024
Published online: August 6, 2024
Processing time: 72 Days and 21.4 Hours
Diaphragmatic paralysis is typically associated with phrenic nerve injury. Neonatal diaphragmatic paralysis diagnosis is easily missed because its manifestations are variable and usually nonspecific.
We report a 39-week-old newborn delivered via vaginal forceps who presented with tachypnea but without showing other birth-trauma-related manifestations. The infant was initially diagnosed with pneumonia. However, the newborn still exhibited tachypnea despite effective antibiotic treatment. Chest radiography revealed right diaphragmatic elevation. M-mode ultrasonography revealed decreased movement of the right diaphragm. The infant was subsequently diagnosed with diaphragmatic paralysis. After 4 weeks, tachypnea improved. Upon re-examination using M-mode ultrasonography, the difference in bilateral diaphragmatic muscle movement was smaller than before.
Appropriate use of M-mode ultrasound to quantify diaphragmatic excursions could facilitate timely diagnosis and provide objective evaluation.
Core Tip: Diaphragmatic paralysis is typically caused by phrenic nerve injury in the context of birth-related trauma or cardiothoracic surgery. Diagnosis of diaphragmatic paralysis is easily missed because its signs are usually nonspecific. The infant in this case had a lung infection but without showing other manifestations due to birth-related trauma. The infant exhibited tachypnea despite effective antibiotic treatment. Chest radiography revealed an elevated right hemidiaphragm. Diagnosis of diaphragmatic paralysis was confirmed by ultrasonography, which revealed decreased motion of the right diaphragm. Appropriate use of M-mode ultrasound to quantify diaphragmatic excursions could facilitate timely diagnosis and provide objective evaluation.