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August 24, 1963

Spontaneous Reduction of an Incarcerated Acute Diaphragmatic Hernia

JAMA. 1963;185(8):671. doi:10.1001/jama.1963.03060080067024

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SPONTANEOUS REDUCTION of an acute strangulated diaphragmatic hernia must occur only rarely, for no such documented case heretofore has been recorded.

Report of a Case  A 46-year-old widow was admitted to the hospital on June 23, 1960, with the chief complaint of inability to swallow anything for 1 week. She also felt a lumpy and painful sensation over the substernal region. Her history revealed that she had had several similar "attacks" since 1957; but on each of the previous occasions the vomiting and pain disappeared after 2 or 3 days. These "attacks" were described by the patient as a feeling of a lump in the throat and inability to eat or drink anything without initiating severe vomiting. Between these attacks she was asymptomatic.Physical examination revealed an obese woman in acute distress. The main symptoms were persistent substernal pain and continuous retching. The vital signs were: BP 160/88 mm Hg,

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