| Abstract: |
Diaphragmatic hernia is the main surgical condition of the diaphragm. This condition can be classified into congenital (Bochdalack, Morgagni and eventration of diaphragm), traumatic and hiatus hernia (sliding and paraesophageal). The incidence of Congenital Diaphragmatic Hernia (CDH) has been reported as one in 3000-5000 live births; however, in population studies (including cases resulting in premature terminations, still births and neonatal deaths prior to transfer to tertiary centers), the incidence approaches one in 2000. The prognosis of congenital diaphragmatic hernia has improved dramatically in the last decade, and for those infants diagnosed in utero, the survival rate is now as high as 80% with antenatal diagnosis and optimal care. Today, traumatic diaphragmatic hernia has become a lesion of increasing incidence and importance. The early detection of diaphragmatic injury is very important as this will prevent its harmful effects as respiratory distress, herniation of abdominal viscera and also its delayed effects which include the technical problems of repair due to atrophy of remnants of diaphragm and possibility of strangulation. Diaphragmatic injuries can be classified according to the mechanism of injury, side involved, unilateral or bilateral location, clinical sequelae after the onset of injury, and severity of the anatomical disruption. Because the diaphragm is buffered by the liver on the right side, 95% of injuries occur on the left side, bilateral injuries occur in less than 3% of all cases. Unfortunately, the clinical diagnosis of rupture of the diaphragm is difficult and is missed in 7% to 66% of patients. Physical findings were nonspecific, consisting primarily of chest and abdominal wall contusions seen only in 16% of patients and respiratory distress seen in 52% of 60% of patients. The incidence of esophageal hiatal hernia in the general population has been estimated variously at 2 to 6 percent. In addition, hiatal hernia may be noted in an estimated one of every five patients undergoing radiological examination of the esophagus. Hiatal hernia is classified as type I, II, III and IV depending on the specific abnormality present. The term paraesophageal hernia is sometimes used to describe any type; II, III or IV hiatal hernia. Laparoscopic technique has been found to be associated with low morbidity and mortality rates, short hospital stay, decreased postoperative pain, and early return to full activity.Objectives: The aim of this work is to give a recent data about diaphragmatic hernia including different methods of diagnosis, different surgical approaches and recent trials in surgery to make an updated essay.
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