目的总结以闭襻性肠梗阻为首发表现的膈疝的诊治经验。方法对我科收治的以闭襻性肠梗阻为首发表现的1例膈疝患者的临床资料进行回顾性分析,并结合文献进行总结。结果经全胸部X线平片、立位腹部X线平片及胸腹部CT明确诊断为闭襻性结肠梗阻、创伤性膈疝(疝内容物为横结肠),急诊手术行嵌顿的疝内容物复位、膈肌修补及切除阑尾经阑尾残端行肠管减压术,术后患者恢复良好。结论仔细的病史采集和查体是明确诊断的基础,全胸部X线平片、立位腹部X线平片及胸腹部CT是明确诊断的重要方法,诊断明确后应及时手术,术中结肠梗阻可经阑尾残端行肠管减压。 Objective To summarize the experience of diagnosing and treating diaphragmatic hernia with closed intestinal obstruction. Methods A retrospective analysis was performed on the clinical data of one case of diaphragmatic hernia who was treated with closed intestinal obstruction in our department and the literature was summarized. The results of the chest X-ray film, the position of the abdomen X-ray film and chest and abdomen CT was diagnosed as closed obstruction, traumatic diaphragmatic hernia (hernia contents of the transverse colon), emergency operation incarcerated hernia content reset , Diaphragm repair and resection of the appendix via the appendix stump bowel decompression, postoperative patients recovered well. Conclusions Careful medical history collection and physical examination are the basis of definite diagnosis. X-ray plain film, orthostatic X-ray film and chest and abdomen CT are the important methods to confirm the diagnosis. After diagnosis, timely operation, intraoperative and colonic obstruction Prosthetic stump line intestinal decompression.