Limitation of diaphragm movement in the presence of certain intra-abdominal lesions is well known. About twenty years ago Czerny1 cited postoperative limitation, with its resulting pulmonary congestion, as one of the causes of postoperative pneumonia. The diagnostic importance of the position of the diaphragm and of its motility in differentiating between supraphrenic and subphrenic disease is often referred to in the literature.2 The lesions to which this effect on the diaphragm is attributed are those that involve contiguous organs. Thus, Hubeny3 cites gastric ulcer located at the esophageal opening. Hughes4 says:
The diaphragm, if its peritoneal surface be inflamed or irritated from any cause whatever, e. g., a perforating gastric ulcer, will be thrown out of action in the same way as the abdominal muscles. If only one half is affected, that half will not move so freely as normally, and it is probably on this
SALE L. A STUDY OF DIAPHRAGMATIC MOVEMENTS IN ACUTE ABDOMINAL INFLAMMATION. JAMA. 1918;71(7):505–508. doi:https://doi.org/10.1001/jama.1918.02600330003002
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