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In 20 newborns with congenital diaphragmatic hernia the state of the pulmonary function was studied through the blood gas values (PO2 and PCO2 on breathing air and 100% oxygen spontaneously or with mechanical ventilation). The group of survivors presented a normal or slightly altered pulmonary function, whilst in the group that died the pulmonary function was severely altered. Up to now, and in accordance with the results obtained, none of the proposed hypothesis (pulmonary atelectasis, extra-pulmonary right-to-left shunt, pulmonary hypoplasia) explain this alteration in a satisfactory manner. From the prognostic point of view, if the levels of gases are spontaneously normal or with administration of oxygen and/or assisted, ventilation a level of PO2 higher than 230 and of PCO2 lower than 70 is obtained, prognosis is excellent. If these levels are not obtained the prognosis is nearly always fatal and the value of the intervention questionable.

This presents the method to be followed for the valuation of the gastro-esophagic function in patients with sliding hiatal hernia, twenty-one patients with this diagnosis were studied through X-Rays. Besides gastric and esophagic endoscopy, a complete clinical examinations was made to compare the information obtained from the studies, with the direct measurement of the contractions of the esophagus and the lower sphincter through conventional manometric methods. The relationship between the simptoms and the clinical procedures done in the patients were observed as was the usefulness of esophagic manometry to detect not only the direct pressure of the gastro-esophagic sphincter, but also to determine the concurrent motor changes that can occur in patients which show hiatal hernia. The benefit of this studies to decide the therapeutic handling, specially surgical, is discussed.