Abstract VISCERAL complications associated with the presence of portions of the gastrointestinal tract as integral parts of diaphragmatic hernias are not common but may be of extreme gravity. We are presenting a series of five cases of diaphragmatic hernia with serious visceral complications. Two of these cases were caused by blunt trauma to the chest. In one case, hernia developed subsequent to a Smithwick type sympathectomy. In a hernia through the foramen of Morgagni symptoms developed only after postoperative distention consequent to a cup arthroplasty. In one case of an esophageal hiatal hernia, a secondary short esophagus and complete esophageal obstruction developed. The difficulties of diagnosis and surgical repair in these cases will be presented. If the hernial content contains esophagus, stomach, duodenum, small intestine, or colon, the visceral accidents may be arranged in order of increasing seriousness as follows: obstruction, incarceration, and strangulation. Incarceration may occur from the development of References 1. Swan, H.; Maresh, G.; Johnson, M. E., and Warner, G.: The Experimental Creation and Closure of Auricular Septal Defects , J. Thoracic Surg. 20:542-551 ( (Oct.) ) 1950. 2. Forsee, J. H.; Swan, H., II; Goyette, E. M., and Makel, H. P.: Calcification of the Pericardium , U. S. Armed Forces M. J. 2:663-666 ( (April) ) 1951. 3. Smithwick, R. H.: A Technic for Splanchnic Resection for Hypertension: Preliminary Report , Surgery 7:1-8 ( (Jan.) ) 1940. 4. Wolfson, S. A., and Goldman, A.: Strangulating Hernia of Liver , Surgery 24:846-852 ( (Nov.) ) 1948. 5. Swan, H.: Personal communication to the authors. 6. Allison, P. R.: Peptic Ulcer of the Esophagus , Thorax 3:20-42 ( (March) ) 1948.Crossref 7. Harrington, S. W.: Diagnosis and Treatment of Various Types of Diaphragmatic Hernia , Am. J. Surg. 50:381-446 ( (Nov.) ) 1940.Crossref
A.M.A. Archives Surgery – American Medical Association
Published: Jul 1, 1952
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