Skip to main content
California Medicine logoLink to California Medicine
. 1959 Nov;91(5):251–254.

RIGHT DIAPHRAGMATIC HERNIA SECONDARY TO TRAUMA—With Report of Two Cases

Newell E Wood, Francis L Stutzman
PMCID: PMC1577925  PMID: 13845825

Abstract

With automobile accidents at high speed on the increase, some previously rare injuries are becoming more common. Rupture of the left diaphragm is fairly common. On the right, it has been believed rare. The diagnosis has often been missed for many years after the causative injury.

Any suspicious x-ray film shadow at the base of the right lung field after injury such as those that occur in accidents of great impact should arouse the physician's suspicions. A mushroom-shaped mass on the lateral x-ray view is characteristic.

Introduction of pneumoperitoneum may help in diagnosis. Only if the peritoneal and pleural cavities communicate will this procedure produce a pneumothorax.

Surgical correction is indicated in all cases. This is best done through the chest. The right lobe of the liver usually must be reduced. In general the results are excellent.

Full text

PDF

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. CARTER B. N., GIUSEFFI J., FELSON B. Traumatic diaphragmatic hernia. Am J Roentgenol Radium Ther. 1951 Jan;65(1):56–72. [PubMed] [Google Scholar]
  2. CHAMBERLAIN J. M., FORD J. M. Diaphragmatic hernia produced by indirect violence. Surg Clin North Am. 1953 Oct;:1505–1509. doi: 10.1016/s0039-6109(16)34048-8. [DOI] [PubMed] [Google Scholar]
  3. CHILD C. G., 3rd, HARMON G. S., DOTTER C. T., STEINBERG I. Liver herniation simulating intrathoracic tumor. J Thorac Surg. 1951 Apr;21(4):391–393. [PubMed] [Google Scholar]
  4. DUGAN D. J., MERRILL D. L. Right phrenohepatic incarceration. Am J Surg. 1957 Aug;94(2):208-15; discussion, 215-6. doi: 10.1016/0002-9610(57)90647-5. [DOI] [PubMed] [Google Scholar]
  5. EVANS C. J., SIMPSON J. A. Fifty-seven cases of diaphragmatic hernia and eventration. Thorax. 1950 Dec;5(4):343–361. doi: 10.1136/thx.5.4.343. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. HARRINGTON S. W. Esophageal hiatus diaphragmatic hernia. Rocky Mt Med J. 1952 Aug;49(8):665–667. [PubMed] [Google Scholar]
  7. HOLLANDER A. G., DUGAN D. J. Herniation of the liver. J Thorac Surg. 1955 Apr;29(4):357–367. [PubMed] [Google Scholar]
  8. KNOEPP L. F. Unusual diaphragmatic hernia with displaced liver. J Thorac Surg. 1951 Apr;21(4):394–397. [PubMed] [Google Scholar]
  9. Keene C. H., Copleman B. Traumatic Right Diaphragmatic Hernia: Case with Delayed Herniation of the Liver and Gallbladder. Ann Surg. 1945 Aug;122(2):191–196. doi: 10.1097/00000658-194508000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. LAM C. R. Treatment of traumatic hernia of the diaphragm. Arch Surg. 1950 Mar;60(3):421–430. doi: 10.1001/archsurg.1950.01250010440001. [DOI] [PubMed] [Google Scholar]
  11. MANLOVE C. H., BARONOFSKY I. D. Traumatic rupture of both leaves of the diaphragm. Surgery. 1955 Mar;37(3):461–462. [PubMed] [Google Scholar]
  12. NEAL J. W. Traumatic right diaphragmatic hernia with evisceration of stomach, transverse colon and liver into the right thorax. Ann Surg. 1953 Feb;137(2):281–284. doi: 10.1097/00000658-195302000-00024. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Rives J. D., Baker D. D. ANATOMY OF THE ATTACHMENTS OF THE DIAPHRAGM: THEIR RELATION TO THE PROBLEMS OF THE SURGERY OF DIAPHRAGMATIC HERNIA. Ann Surg. 1942 May;115(5):745–755. doi: 10.1097/00000658-194205000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. SHOSKES M., LOVELOCK F. J. Post traumatic diaphragmatic herniation of a segment of the liver simulating an anomalous lobe of the liver. Am J Roentgenol Radium Ther Nucl Med. 1953 Oct;70(4):572–575. [PubMed] [Google Scholar]
  15. STRODE E. C., VANCE C. A. Herniation of the right diaphragm secondary to trauma. Ann Surg. 1953 May;137(5):609–615. doi: 10.1097/00000658-195305000-00004. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. UNGER S. M. Right-sided traumatic diaphragmatic hernia simulating a pleural effusion. J Am Med Assoc. 1953 Feb 28;151(9):734–736. doi: 10.1001/jama.1953.02940090036007e. [DOI] [PubMed] [Google Scholar]

Articles from California Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES