[Diaphragmatic hernias in adults].

The sliding hiatal hernias are the most usual diaphragmatic hernias in adults. Their recognition and the survey of their complications are performed with esophagoscopy. Antisecretory drugs are efficient in case of esophagitis. Indications for surgery are discussed in young patients with a long-term medical treatment. The paraesophagal hernias even with a total intrathoracic volvulus of the stomach are operated through abdominal approach. The Morgagni hernias are uncommon and rarely symptomatic. The Bochdaleck hernias are exceptionally revealed at adult age. Traumatic hernias occur after penetrating injury or blunt diaphragmatic rupture in automobile accident victims. Association of serious injuries and difficulty to identify the diaphragmatic injury may explain the delay in the diagnosis. Optimal management consists of early repair of the diaphragmatic injury through an abdominal approach, to avoid strangulation of the herniated organs.