Couraud L, Barandon E, Desplantez J, Zimmermann J M
Sem Hop. 1978;54(45-46):1457-61.
The authors report the cure of six recent cases of strangulated or impacted diaphragmatic hernia: 3 post-traumatic, 2 hiatal, one congenital. Strangulation or simple impaction are responsible for ischemic phenomena with necrosis and intrathoracic visceral perforation. Intensive care for respiratory, cardio-vascular and metabolic complications, including gastric aspiration, has transformed the prognosis which was recently so poor in this condition. The thoracic approach is advised for the usual reasons and owing to frequent intrathoracic adhesions. It is also advised for ease of treatment of the strangulated viscus and local septic complications.
作者报告了近期6例绞窄性或嵌顿性膈疝的治愈情况：3例为创伤后，2例为食管裂孔疝，1例为先天性。绞窄或单纯嵌顿会导致缺血性病变，伴有坏死和胸腔内内脏穿孔。对包括胃内容物误吸在内的呼吸、心血管和代谢并发症进行重症监护，改变了这种疾病近期预后极差的情况。由于常见原因以及胸腔内频繁粘连，建议采用经胸入路。这也有利于对绞窄脏器和局部感染并发症进行治疗。
