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October 1961

Diaphragmatic Hernia in Infants Under One Year of Age

Author Affiliations

From the Surgical Clinic of the Children's Hospital of Pittsburgh, and the Department of Surgery of the University of Pittsburgh School of Medicine.; Professor of Pediatric Surgery (Dr. Kiesewetter); Teaching Fellow in Surgery (Dr. Gutierrez), and Assistant Clinical Professor of Surgery (Dr. Sieber), University of Pittsburgh.

Arch Surg. 1961;83(4):561-572. doi:10.1001/archsurg.1961.01300160073009

Diaphragmatic hernia is one of the surgical emergencies of childhood because of the life-threatening cardiorespiratory embarrassment frequently associated with it. This congenital condition is characterized by varying degrees of protrusion of the abdominal viscera into the thoracic cavity through an abnormal opening in the diaphragm; this opening results from a defect in the complex embryologic development of the diaphragmatic partition between the thoracic and abdominal cavities.

A review of the literature 30 years ago9 showed a 75% mortality associated with this pathological condition if left untreated; one eminent pathologist stated15 that "only one [such] infant delivered in our hospital has survived longer than 6 hours." At present, the decreasing rate of loss can be attributed to earlier recognition, immediate surgical intervention, improved anesthesia, and better postoperative care. The purpose of this paper will be to present the authors' experience with this condition in children under 12 months of

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