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March 1967

Late Recognition and Treatment of Traumatic Diaphragmatic Hernias

Author Affiliations

Madison, Wis
From the Department of Surgery, University of Wisconsin Medical School, Madison.

Arch Surg. 1967;94(3):330-334. doi:10.1001/archsurg.1967.01330090024006

AS EARLY as 1579 Ambrose Paré described some of the symptoms of traumatic diaphragmatic hernia, which is translated as follows.

"When the Diaphragma or Midriff is wounded, the party affected is troubled with a weight or heaviness in that place, he is taken with a Delirium, or Raving, by reason of the sympathy of the Nerves of sixth conjugation which are spread over the Midriff; difficulty of breathing, a cough and sharp pain troubles the Patient, the Guts are drawn upwards; so that it sometimes happens by the vehemency of breathing, that the Stomach and Guts are drawn through the wound into the capacity of the Chest, which thing I observed in two."1

The first antemortem diagnosis of a traumatic hernia was not made until 1853; and in 1886 the first successful repair of this defect was accomplished.2,3

The diaphragmatic rupture resulting from either blunt or penetrating trauma

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