Diaphragmatic hernia occurs frequently and often is asymptomatic or produces mild symptoms which are controlled easily by medical management. Hernia of the diaphragm, however, may produce serious complications associated with considerable morbidity and possible fatality. In the past, the incidence of recurrence following herniorrhaphy was rather high and the risk of the operative procedure was great enough to influence many physicians rarely to recommend repair of a diaphragmatic hernia. With better methods for evaluating and improving the status of the patient before and after surgical treatment and by employing much safer anesthesia and refined surgical techniques, the operative mortality has been diminished to a very low figure and recurrences are exceptional. With this change in results, perhaps, this disease and its complications should be re-evaluated.
During the period between January, 1948, and April, 1959, I performed diaphragmatic herniorrhaphy for 133 patients seen at the Scott and White Clinic. Three deaths