Akhtar Jamal, Siddiqui Mohammed Azfar, Khan Nafees Ahmad, Alam Md Arif
Department of Tuberculosis and Respiratory Diseases, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh 202002, UP, India.
Malays J Med Sci. 2013 Jul;20(4):98-101.
Phrenic nerve palsy causing hemidiaphragm paralysis is a very uncommon feature of thoracic aortic aneurysm. In one case, a 45-year-old man complained of chronic chest pain, dysphagia, and hoarseness of voice; posteroanterior view chest radiograph revealed lobular enlargement of the superior mediastinum and elevated right hemidiaphragm. Contrast-enhanced computed tomography (CT) of the thorax revealed a giant partially thrombosed aneurysm originating from the ascending aorta and extending into the aortic arch, causing a widening of the aorta-pulmonary window and a compression of the thoracic esophagus. Right hemidiaphragm elevation was explained by the gross mass effect of the aneurysm on the right hilum, causing right phrenic nerve palsy. The patient was to be operated on for surgical correction of the aneurysm, but died before surgery due to spontaneous rupture.
膈神经麻痹导致半侧膈肌瘫痪是胸主动脉瘤非常罕见的特征。在一个病例中，一名45岁男性主诉慢性胸痛、吞咽困难和声音嘶哑；胸部后前位X线片显示上纵隔小叶状增宽和右半侧膈肌抬高。胸部增强计算机断层扫描（CT）显示一个巨大的部分血栓形成的动脉瘤起源于升主动脉并延伸至主动脉弓，导致主动脉-肺动脉窗增宽和胸段食管受压。右半侧膈肌抬高是由于动脉瘤对右肺门的巨大肿块效应导致右膈神经麻痹所致。该患者原计划接受手术矫正动脉瘤，但术前因动脉瘤自发破裂死亡。
