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November 1959

Traumatic Pericardial Diaphragmatic Hernia

Author Affiliations

From the Surgical Service, Ball Memorial Hospital, Muncie, Indiana and the Department of Surgery, Indiana University School of Medicine. Supported in part by a grant from the Indiana Heart Foundation.

AMA Arch Surg. 1959;79(5):827-830. doi:10.1001/archsurg.1959.04320110129022

Traumatic diaphragmatic hernia is relatively rare. The defect in the diaphragm may be produced by blunt trauma to the thorax or abdomen or by penetrating gunshot or stab wounds. The herniation generally is into one of the pleural spaces and may lead to pulmonary or gastrointestinal symptoms. The hazard of ischemic gastrointestinal obstruction in these cases has been emphasized by Carter and Guiseppi.2 In a few recorded instances, the herniation has occurred into the pericardial sac.

The true nature of the pathology in these cases generally has remained obscure prior to operation, and these patients may have been treated for varying periods of time as "cardiac" problems. Only four cases of traumatic pericardial diaphragmatic hernia have been reported. The first of these was described by Crawshaw3 in 1952. Because of the limited number of recorded cases, it has seemed desirable to report a case of traumatic pericardial diaphragmatic