The correct evaluation of upper abdominal symptoms in the presence of radiologic evidence of diaphragmatic hernia frequently poses a most difficult diagnostic problem. It is often impossible to establish a correct diagnosis on the basis of symptomatology alone. This is particularly true in that group of patients who for one reason or another may be suspected of having liver, biliarytract, or cardiovascular disease.
At Letterman General Hospital a group has been investigating the effect of pneumoperitoneum as an aid in the differential diagnosis in selected patients who, after careful clinical and x-ray investigations, were thought to be suffering from the effects of a hiatus hernia. The purpose of the study was to test the validity of symptomatic relief following pneumoperitoneum in patients in whom the clinical diagnosis was relatively well established.
If intra-abdominal air produced relief of symptoms in a high per cent of selected cases of symptomatic hiatus hernia,
BERRY WC, HOLBROOK JP, LANGDON EA, MATHEWSON C. A Study of Hiatal Herniae, Using Pneumoperitoneum: A Preliminary Report. AMA Arch Surg. 1956;72(6):1014–1017. doi:https://doi.org/10.1001/archsurg.1956.01270240126018
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