Evidence map›Paper›PMID 31139880›Full record

ArticlePediatric radiology2019

Ultrasound evaluation of right diaphragmatic eventration and hernia.

Boaz Karmazyn, Andrew J Shold, Lisa R Delaney, Brandon P Brown, Megan B Marine, S Gregory Jennings, Brian W Gray

Abstract readComparative Study
PubMed Publisher
In one paragraph

Article in Pediatric radiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.8field-weighted citation impact, top 16% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 17 citations in OpenAlex.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 1 country.

Boaz KarmazynDepartment of Radiology and Imaging Sciences, Riley Hospital for Children, Indiana University, 705 Riley Hospital Dr., Rm. 1053, Indianapolis, IN, 46202, USA. bkarmazy@iupui.edu.ORCID 0000-0003-1674-1789
Andrew J SholdIndiana University School of Medicine, Indianapolis, IN, USA.
Lisa R DelaneyDepartment of Radiology and Imaging Sciences, Riley Hospital for Children, Indiana University, 705 Riley Hospital Dr., Rm. 1053, Indianapolis, IN, 46202, USA.
Brandon P BrownDepartment of Radiology and Imaging Sciences, Riley Hospital for Children, Indiana University, 705 Riley Hospital Dr., Rm. 1053, Indianapolis, IN, 46202, USA.
Megan B MarineDepartment of Radiology and Imaging Sciences, Riley Hospital for Children, Indiana University, 705 Riley Hospital Dr., Rm. 1053, Indianapolis, IN, 46202, USA.
S Gregory JenningsDepartment of Radiology and Imaging Sciences, Indiana University, Indianapolis, IN, USA.
Brian W GrayDepartment of Pediatric Surgery, Riley Hospital for Children, Indiana University, Indianapolis, IN, USA.
Riley Hospital for Children · USIndiana University – Purdue University Indianapolis · USIndiana University School of Medicine

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundA hernia is due to a defect in the diaphragm. An eventration is due to a thinned diaphragm with no central muscle. Distinguishing right diaphragmatic hernia from eventration on chest radiographs can be challenging if no bowel loops are herniated above the diaphragm. Experience is limited with postnatal ultrasound (US) evaluation of diaphragmatic hernia or eventration.

objectiveTo evaluate for specific US signs in the diagnosis of right diaphragmatic hernia and eventration. MATERIALS AND

methodsWe identified all patients (January 2007-December 2017) with right diaphragm US and surgery for eventration or hernia. We reviewed medical charts, and US images/reports for clinical presentation and diaphragm abnormalities. Surgical diagnosis was considered the reference standard.

resultsSeventeen children (mean age: 5 months) had US examination before surgery for hernia (n=9) or eventration (n=8). The most common presentation was respiratory distress. In the US reports, hernia was correctly diagnosed in all patients and three patients with eventration were misdiagnosed as hernia, yielding 100% sensitivity and 62.5% specificity. In a retrospective evaluation of the US studies, a combination of folding of a free muscle edge with a narrow angle waist had 100% specificity for hernia and was seen in 7/9 children with hernia. Combination of a broad angle waist and hypoechoic strip of diaphragmatic muscle covering the waist had 100% specificity for eventration and was demonstrated in 4/8 children with eventration. Five of 17 patients (31.6%) had no specific sign that differentiated hernia from eventration.

conclusionOn US, folding of the free edge of the diaphragm and a narrow angle waist are specific for hernia; a broad angle waist with muscle covering the elevated area is specific for eventration. Definitive differentiation between eventration and hernia may not be possible in about a third of patients.

Indexed as

Age FactorsChildChild, PreschoolCohort StudiesDiagnosis, DifferentialDiaphragmatic EventrationFemaleFollow-Up StudiesHernias, Diaphragmatic, CongenitalHerniorrhaphyHumansInfantMalePreoperative CareRetrospective StudiesRisk AssessmentChildrenCongenital diaphragmatic herniaDiaphragmEventrationHerniaInfantsUltrasound

Identifiers

PMID31139880
OpenAlexW2947911586

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.