Rupture of Diaphragm Following Repair of Hiatal Hernia

Abstract

During the past decade, the significance of diaphragmatic hiatal hernia as an important pathological entity has become increasingly evident. Moreover, the repair of hiatal hernias, as described by Allison,¹has given impetus to the surgical repair of these defects. The supradiaphragmatic approach recommended by Allison has many advocates. Since the initial enthusiasm for this type of procedure there have been many proponents for the utilization of the infradiaphragmatic approach.^2,3 The supporters of the abdominal approach in hiatal hernioplasties have emphasized the fact that other disease processes are often present which require definitive surgical treatment. Beretta and Jordan⁴report more than 50% of cases repaired surgically have other intra-abdominal conditions. Other reasons given in support of the abdominal approach are fewer hospital days, less postoperative pain and decreased operative morbidity and mortality. Berman⁵has postulated that peptic esophagitis is only part of a disease complex affecting that