Strangulated diaphragmatic hernia with gangrene and perforation of the stomach.

نویسندگان

  • L H BOSHER
  • L FISHMAN
  • W R WEBB
  • L OLD
چکیده

Incarceration of stomach in a diaphragmatic hernia with or without simultaneous inclusion of bowel usually signals a surgical emergency. Symptoms of pain, vomiting and occasionally bleeding, together with roentgenographic studies should lead to easy recognition and appropriate surgical therapy. Rarely, strangulation occurs early; then the above symptoms may be overshadowed by the rapid onset of shock. Incarceration with acute gastric dilatation may produce serious derangement of cardiopulmonary physiology. The superficial resemblance of the clinical and roentgenographic findings to tension pneumothorax may lead the unwary surgeon to institute improper therapy. The correct diagnosis, if suspected, can almost always be readily confirmed roentgenographically after the passage of a stiff stomach tube with or without the instillation of barium. After preliminary decompression of the stomach in this manner, immediate thoracotomy should be performed to complete the relief of respiratory and circulatory embarrassment and to avert the onset of strangulation with possible gangrene and rupture of the stomach.

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عنوان ژورنال:
  • Surgery

دوره 40 4  شماره 

صفحات  -

تاریخ انتشار 1956