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ARTICLE |

DIAPHRAGMATIC HERNIAS WITH VISCERAL COMPLICATIONS

DAVID H. WATKINS, M.D.; FRED R. HARPER, M.D.; WILLIAM B. CONDON, M.D.
AMA Arch Surg. 1952;65(1):95-108. doi:10.1001/archsurg.1952.01260020107010.
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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

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