Name seven causes of an elevated hemidiaphragm. What is the workup?

Elevated right hemidiaphragm.

7 causes of an elevated hemidiaphragm include:

1. volume loss (lobar collapse, atelectasis)
2. splinting 
3. pleural disease (mass, effusion)
4. diaphragmatic hernia 
5. eventration
6. phrenic nerve paralysis (most commonly from iatrogenic injury after cardiothoracic or cervical procedure; or from compression by malignancy)
7. abdominal disease (abscess, dilated viscera)

If the cause is not immediately obvious from initial history and physical, further workup - often as an outpatient - should be pursued and may include examination of diaphragmatic excursion under fluoroscopy and/or chest CT.  For patients found to have phrenic nerve paralysis, treatment is generally conservative unless the patient is symptomatic in which case operative management (diaphragmatic plication) is an option.


Source

ACS Surgery: Principles & Practice