This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citing articles on Web of Science (13)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

Mechanism of Pain, and Surgical Therapy

DONALD B. EFFLER, M.D.; LAURENCE K. GROVES, M.D.

AMA Arch Surg. 1957;75(4):639-646.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

Akerlund's classification¹ of hiatus hernias consisted of three categories: paraesophageal, pulsion type, and short esophagus. Although other descriptive terms have been applied to hiatus hernias, Akerlund's terminology is in common use today. The surgeon, however, recognizes two major types of hiatus hernia: (1) that created by pulsion—a normal length of esophagus that is forced into the mediastinum by increased intra-abdominal pressure, and (2) that created by traction—a progressive shortening of the esophagus. It matters little whether the pulsion type of hernia is perihiatal (Sweet²), paraesophageal (Akerlund¹), or sliding (Allison³); in all types the basic mechanism is the same, and the method of surgical repair is identical. It is, however, of more than academic interest that the surgeon recognize the hernia that is produced by traction and is associated with significant shortening of the esophagus.

Conflicting views appear in the voluminous published reports in which this subject . . . [Full Text PDF of this Article]

Author Affiliations
Cleveland

From the Department of Thoracic Surgery, The Cleveland Clinic Foundation and The Frank E. Bunts Educational Institute.

Footnotes
Submitted for publication March 4, 1957.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?