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Herniation of an abdominal organ through the diaphragm into the thorax occurs frequently, and unless physicians are aware of the significance of symptoms produced by this abnormality, the nature of the disability may not be detected. Herniation through the diaphragm into the thorax may result from congenital maldevelopment or from rupture of a normal diaphragm by external trauma. In many instances a trivial congenital defect in the diaphragm that does not cause symptoms may be increased by the thoracic action of suction and positive intraabdominal pressure so that later in life significant discomfort is produced. The purpose of this paper is not to discuss all types of diaphragmatic hernia, but to direct attention to two types in which dysphagia is often the predominating symptom.
In patients with hernia of one of these types, the esophageal opening in the diaphragm is larger than normal, and a portion of the stomach, usually
VINSON PP. TREATMENT OF DYSPHAGIA FROM HERNIA THROUGH ESOPHAGEAL HIATUS IN DIAPHRAGM. Arch Otolaryngol. 1943;38(1):27–31. doi:10.1001/archotol.1943.00670040036004