Approach and management of diaphragmatic paralysis in adults

3 years ago, 38-year-old male, with no relevant personal pathological history, began to present exertional dyspnea, gastroesophageal reflux, retrosternal pyrosis, dyspepsia and postprandial abdominal distension after a traffic accident. A study protocol was initiated, where cabinet studies documented elevation of the left hemidiaphragm documented. minimally invasive approach performed finding approximately 8 cm in relation contralateral diaphragm without evidence paraesophageal hernia. Mayo type diaphragmatic plication non-absorbable suture (polypropylene 1) complications. With favorable evolution, he started oral route hours postoperatively, discharged 48 surgery due clinical improvement reflux. Surgical affected is successful carefully selected patients severe symptoms thought be unilateral paralysis. Studies demonstrate several parameters, including lung respiratory muscle function, exercise endurance, blood gas exchange, possibly dyspnea.