. Surgery, its principles and practice . ^ of hernia is morefrequently found on theleft than on the right side,in the proportion of 2 to 1in the true, and 6 to 1 inthe false hernias. Thisgreater frequency on theleft side is partly ex-plained by the position of the liver on the right side, which acts as a barrier, protecting the dia-phragm, and partly by the fact that in traumatic direct hernia, especiallyfrom stab wounds, the wounds are more frequently found upon the leftside of the abdomen. Although the diagnosis has been made in only six instances, there arecertain fairly characteristic sign
. Surgery, its principles and practice . ^ of hernia is morefrequently found on theleft than on the right side,in the proportion of 2 to 1in the true, and 6 to 1 inthe false hernias. Thisgreater frequency on theleft side is partly ex-plained by the position of the liver on the right side, which acts as a barrier, protecting the dia-phragm, and partly by the fact that in traumatic direct hernia, especiallyfrom stab wounds, the wounds are more frequently found upon the leftside of the abdomen. Although the diagnosis has been made in only six instances, there arecertain fairly characteristic signs which should make one suspect the. Fig. 64.—A Newborn Child with a True Left-sidedCongenital Diaphragmatic Hernia (Sultan). 94 HERNIA. existence of a diaphragmatic hernia. The most important physicalsign is dextra cardia, or displacement of the heart to the right side. An-other sign is an area of tympanitic resonance over the thorax. Thisarea is apt to vary in size at different times. As the stomach is oftenfound to be the contents of a diaphragmatic hernia, the injection ofbismuth into the stomach, and then taking an x-ray photograph, willshow the abnormal position of the organ. Digestive disturbances, gas-tric pain, and nausea are oftenpresent. These symptoms fre-quently come on suddenly andvary greatly in intensity. Incases of traumatic origin, inwhich the hernia develops sud-denly, the symptoms may bevery severe, depending upon theamount of intestine forced intothe thoracic cavity. In some in-stances there may be very greatdyspnea and cyanosis. Occasion-ally, especially in the new-born,the entire contents of the
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