[Haemorrhagic complications of diaphragmatic hernias. 38 cases (author's transl)]

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.