Diaphragmatic hernia presenting itself as a surgical emergency

Thirty-four cases of diaphragmatic rupture which presented themselves as acute emergencies are reviewed. The need for rapid and accurate diagnosis in these urgent cases is stressed and the place of various investigations is discussed. X-ray examination of the chest was found to be the best diagnostic aid, and in the difficult case computerized tomographic scanning was found to be time saving and accurate. Surgical repair through an abdominal incision is advised for most cases.