Boutelier P, Ostovany J, de Mestier P
Nouv Presse Med. 1980 Nov 1;9(41):3071-4.
In this retrospective study two-thirds of 38 haemorrhagic diaphragmatic hernias presented as overt bleeding and one-third as anaemia. Fiberoscopy was of paramount importance for locating the bleeding lesion, which was superficial in 75% of the cases and lied in the neck of the hernia as often as in the lower oesophagus. The pathogenic mechanisms were varied and included gastro-oesophageal reflux and purely mechanical phenomena. Thirty-five of these patients were operated upon, including 3 emergencies. The surgical procedure adopted was invariably conservative and aimed at reducing the hernia and at preventing the reflux; it had remarkable and lasting haemostatic effects.
在这项回顾性研究中,38例出血性膈疝中有三分之二表现为明显出血,三分之一表现为贫血。纤维内镜检查对于确定出血病变至关重要,75%的病例中出血病变位于浅表,且在疝颈部和食管下段出现的频率相同。致病机制多种多样,包括胃食管反流和单纯的机械性现象。其中35例患者接受了手术,包括3例急诊手术。所采用的手术方式均为保守性的,旨在还纳疝并防止反流;具有显著且持久的止血效果。