American journal of surgery
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Twenty-seven reported cases of pericardial diaphragmatic hernia are reviewed and another case is added. This entity may be congenital or traumatic in origin, the latter being more frequent at a ratio of 2:1. All patients except one were male and the mean age at diagnosis was 40 years. ⋯ We believe the anterior abdominal approach is preferable to the transthoracic approach in reducing the hernia and repairing the defect because it affords better exposure and easier accessibility to other intraabdominal disease and can easily be converted into a median sternotomy if needed. The stomach and transverse colon became herniated most frequently and in only three cases was a sac found. The defect involves the central leaflet of the diaphragm and primary repair generally results in a good prognosis.