Diaphragmatic hernia

Abstract

Diaphargmatic hernia may endanger life because of interference with cardiorespiratory function or because of incarceration. Since there is a wide spectrum of symptoms and signs, there is no typical clinical picture. Awareness of the problem is necessary for early diagnosis and prompt treatment. Delay in diagnosis is the commonest cause of death. X-rays, particularly in combination with pneumoperitoneum, enable exact diagnosis in almost every patient. Five patients illustrating the wide spectrum of anatomic-pathologic changes and clinical signs are described. Early surgical treatment is always advisable but may not be possible because of a precarious general condition or advanced age. Diaphragmatic hernia, in the strict sense, must not be confused with hiatus hernia, an entirely different entity, with problems of its own.