Strangulated Right-Sided Diaphragmatic Hernia

Abstract

Strangulation of a diaphragmatic hernia is, in general, a rather rare phenomenon, in contrast to the common occurrence of strangulation in other types of hernia. An explanation for this is that the great majority * of diaphragmatic hernias are of the esophageal hiatus type, in which usually the stomach is the only viscus herniated. The heavy muscular wall and excellent blood supply of the stomach protect it from strangulation, though incarceration is common enough. In the congenital group of diaphragmatic hernias, including the pleuro-peritoneal type (Bochdalek's), congenital absence of the posterior diaphragm, and the subcostosternal type (foramen of Morgagni), though various viscera may be extruded into the chest, strangulation is still uncommon. Intestinal obstruction, however, is a real possibility, especially in the large defects of the newborn.† Far exceeding the expected incidence of strangulation, according to its proportion to other diaphragmatic hernia types, is the traumatic type. In a collection of