Pemantauan Jangka Panjang pada Pasien Eventerasi Diafragma Paskaplikasi dengan Pneumonia Berulang, Palsi Erb, dan Keterlambatan Perkembangan Global
Dea Sella Sabrina, dr. Desy Rusmawatiningtyas, Sp.A(K); dr. Amalia Setyati, Sp.A(K)
2025 | Tesis-Spesialis | S2 Ilmu Kesehatan anak
Background: Diaphragmatic eventration is a rare condition that can lead to respiratory distress, recurrent respiratory infections, and developmental delay. Long-term monitoring is necessary to optimize management and prevent complications. This case report discusses 20 months of monitoring a patient with diaphragmatic eventration post-plication, recurrent pneumonia, Erb's palsy, and global developmental delay.
Objective: To monitor a patient with post-plication diaphragmatic eventration, identify risk factors, and provide comprehensive management in various aspects such as respiration, growth, and development. It is hoped that long-term outcomes for patients with diaphragmatic eventration post-plication will improve.
Method: A longitudinal observational study was conducted on a 1-year-old female child with diaphragmatic eventration post-plication. Monitoring included evaluation of nutritional status, developmental status, and recurrence of diaphragmatic eventration. Prognostic variables observed included compliance with physiotherapy, immunization status, and respiratory infections. Data were collected through routine visits, medical records, and home visits.
Results: During 20 months of monitoring, the patient showed significant improvement in nutritional status, with an average weight gain of 180 grams per month and a height increase of 0.9 cm per month. Gross motor and language development improved, although there was still global developmental delay. No recurrence of diaphragmatic eventration was found. Respiratory infections occurred only once during the monitoring period, with environmental improvement and nutritional status as supporting factors. Compliance with physiotherapy and basic immunizations was on schedule; however, additional immunizations such as influenza and pneumococcal vaccines could not be provided due to economic constraints.
Conclusion: Comprehensive long-term monitoring, including nutritional management, physiotherapy, and a healthy environment, plays an essential role in improving clinical outcomes for patients with diaphragmatic eventration post-plication. Additional immunizations and better access to healthcare services are necessary to prevent recurrent infections and support optimal patient development.
Kata Kunci : Eventerasi diafragma, pneumonia berulang, palsi Erb, keterlambatan perkembangan global