'Lelo mākou no kahi hernia ke haʻalele kahi hapa i ka lua e loaʻa mau iā ia, e hele ana i kahi orifice kūlohelohe.

Ināʻoe he hernia hiatal, ʻo ia ka ʻōpū e piʻi aʻe i kahi ʻāpana ma o ka puka liʻiliʻi i kapa ʻia ʻo "esophageal hiatus", aia i ka diaphragm, ka mākala hanu e hoʻokaʻawale i ka lua o ka iwi mai ka ʻōpū.

ʻAe ka hiatus i ka esophagus (= Tube e hoʻopili i ka waha i ka ʻōpū) e hele i loko o ka diaphragm e lawe i ka meaʻai i ka ʻōpū. Inā ākea ia, hiki i kēia wehe ke ʻae i kahi o ka ʻōpū a i ʻole ka ʻōpū holoʻokoʻa, a i ʻole nā ​​mea ʻē aʻe i loko o ka ʻōpū.

Aia ʻelua ʻano nui o hiatus hernia:

• La hernia heʻe a i ʻole ʻano I, e hōʻike ana ma kahi o 85 a 90% o nā hihia.

  ʻO ka ʻaoʻao o luna o ka ʻōpū, ʻo ia ka huina ma waena o ka esophagus a me ka ʻōpū i kapa ʻia ʻo "cardia", piʻi i luna i ka umauma, e hoʻoulu ana i nā wela e pili ana i ka reflux gastroesophageal.

• La hernia paraesophageal a i ʻole ʻolokaʻa a ʻano II paha. ʻO ka hui ʻana ma waena o ka esophagus a me ka ʻōpū e waiho ma kahi ma lalo o ka diaphragm, akā ʻo ka ʻāpana nui o ka ʻōpū "ʻolokaʻa" a hele i loko o ka hiatus esophageal, e hana ana i kahi ʻano o ka ʻeke. ʻAʻole kumu kēia hernia i nā ʻōuli, akā i kekahi mau ʻano hiki ke koʻikoʻi.

Aia kekahi mau ʻano hiatus hernia ʻelua, ʻoi aku ka liʻiliʻi o ka maʻamau, a he ʻano ʻokoʻa ia o ka paraesophageal hernia.

• ʻAno III a huikau paha, ke kūlike ka hernia paheʻe a me parania hernia paraesophageal.
• ʻAno IV, i kūlike i ka hernia o ka ʻōpū holoʻokoʻa i kekahi manawa me ka viscera ʻē aʻe (ʻōpū, ʻūlū, kolona, ​​pancreas…).

ʻO nā ʻano II, III a me IV pū kekahi no 10 a 15% o nā hihia o hiatus hernia.

ʻO wai ka mea i hoʻopili ʻia?

Wahi a nā noiʻi, 20 a 60% o nā mākua i kahi hiatus hernia i kekahi manawa i ko lākou ola. Hoʻonui ka pinepine o ka hiatus hernias me ka makahiki: pili lākou i 10% o ka poʻe ma lalo o 40 a hiki i 70% o ka poʻe ma luna o 60¹.

Eia nō naʻe, paʻakikī e kiʻi i ka prevalence pololei no ka mea he nui nā hiatus hernias asymptomatic (= mai kumu i nā ʻōuli) a no laila ʻaʻole ʻike ʻia.

Nā kumu o ka maʻi

ʻAʻole i hōʻike akāka ʻia nā kumu kūpono o ka hiatus hernia.

I kekahi mau hihia, he hānau hānau ka hernia, ʻo ia hoʻi, mai ka wā hānau mai ia. No muli ia o kahi anomaly o ka hiatus i ākea loa, a i ʻole o ka diaphragm holoʻokoʻa i pani maikaʻi ʻole ʻia.

Eia nō naʻe, ʻo ka hapanui o kēia mau hernias e kū i ka wā o ke ola a ʻike pinepine ʻia i ka poʻe ʻelemākule. ʻO ka wili a me ka ʻoʻoleʻa o ka diaphragm me he mea lā e emi ana me ka makahiki, a hoʻonui ka hiatus i ka ʻae ʻana i ka ʻōpū e piʻi māmā aʻe. Hoʻohui, nā kūkulu e hoʻopili i ka cardia (= ke kinikini gastroesophageal) i ka diaphragm, a e hoʻomau i ka ʻōpū i wahi, ua hōʻino hoʻi me ka makahiki.

ʻO kekahi mau kumu pilikia, e like me ka momona a hāpai paha, hiki ke hoʻopili ʻia me ka hiatus hernia.

Ka papa a me nā pilikia kūpono

La paheʻe hiatus hernia kumu nui loa i ka ʻōpū, akā pinepine ʻole ia koʻikoʻi ʻole.

La ʻōwili hiatus hernia pinepine asymptomat akā makemake e hoʻonui i ka nui ma mua o ka manawa. Hiki ke hoʻopili ʻia me nā pilikia hoʻoweliweli i ke ola, e like me:

• Nā pilikia hanu, inā nui ka hernia.
• Ke hele nei ke kahe kahe liʻiliʻi i kekahi manawa a hiki i ke anemia mai ka nele o ka hao.
• ʻO kahi torsion o ka ʻōpū (= gastric volvulus) ka mea e hōʻeha ai i ka ʻeha ikaika a i kekahi manawa nekrosis (= make) o ka ʻāpana o ka hernia i ka torsion, nele i ka oxygen. Hiki i ka uhi o ka ʻōpū a i ʻole ka esophagus ke haehae, ke kumu o ke kahe ʻana o ka digestive. Pono mākou e hana wikiwiki a hana i ka mea maʻi, ka mea e weliweli paha kona ola.