Diaphragmatic hernia - se le lebaka la ketsahalo?

Ha ho buuoa ka lekhetlo la pele ba "diaphragmatic hernia" e bolela lekholong la bo16 la lilemo. Ho ke ea mofolisi tsebahalang ea nako e - Ambroise Pare. lentsoe lena le lokela ho utloisisoa khukhuneloa ha ba bang ba litho tse ka hare ka o inkela sekoli ho diaphragm ena.

U lokela ho hlokomela hore ka tlas'a irregularities itseng hlahang ho tloha mathata ka ntshetsopeleng embryonic tsa lesea, ho na le ka 'na la ba leeme kapa ka ho feletseng diaphragm likoli ka masea. Boemong bo joalo, ha ditlolo tsena li etsahala ho fihlela sebopeho sa diaphragm eo, hernia ke ke ba le hernia karaoke tren. Ha bopengwi ka ntshetsopeleng e etsahetse ka mor'a hore ho thehoe oa diaphragm lera ke ho phunyelletsa lifilimi e bopilweng ka ba serous hernial karaoke tren ka hernial lesale fupereng na mesifa.

Area mabapi likhopo ho sternum, e leng bosula le bo sa mesifa, ke belegetswe ea sterno-costal hernia. Ho seng joalo, ba ile ba ba bitsoa hernias sternokostalnymi. kotsing ena e bitsoa triangolo sternokostalnym Larrey, 'me e hernia bakileng ho na le, o boetse o bitsoa ka triangolo Larrey o hernia.

Diaphragmatic hernia ka bakoang ke mabaka a fapaneng. A re re, lefu lena le ile classified Petrovsky, ka tsela e latelang:

1. hernia fumaneng ka lebaka la ho lemala (sithabetsang hernia):

- ba bohata;

- 'nete.

2. hernia bao e seng e sithabetsang:

- congenital bohata;

- fokolang ea 'nete hernia lesoba libaka;

- Diaphragmatic hernia orifices:

- 'nete hernia atypical diriswa;

3. hernia esophageal a qalang;

4. seoelo hernia orifices.

Ha diaphragmatic hernia, matšoao a tse amana ka ho toba le bobe kapa likotsi, aroloa feela ho ba bohata le ba 'nete, ho hernia bao e seng e sithabetsang ho ba le tlhophiso pharaletseng. Feela bohata ke congenital hernia seo se etsahala ka lebaka la kholofalo diaphragm (lefarung ka mpeng le cavities thoracic).

Bakeng sa 'nete hernia fokolang diaphragm hernia libaka kenyeletsa sternum-costal triangolo. Sebakeng sena, morpheme le e aroloa ho peritoneum ho poleiti tšesaane ea dinama tse nyenyane tse connective teng pakeng tsa peritoneum le pleura.

Retrostenalnye hernia tšoauoa ka underdeveloped sternum diaphragm area.

seoelo haholo hernia vena cava, ba le kutloelo-bohloko methapo ea kutlo lekhalo le aorta. Mofuta o tloaelehileng haholo (ka 98% ya maemong 'ohle) ke diaphragmatic hiatus hernia.

E na anatomical makgetheng lona. Ho na le mefuta e 'maloa ea lefu lena. hernia tsena ke: hloa, ka phetoho ka metso (ka khutsufatsa, ntle ho khutsufatsa); cardiac; subtotal; kardiofundalnaya; palo yohle.

O teng paraesophageal hernias ba arotsoe ka: mala, pata, fundic, gastrointestinal.

Litsebi khetha pakeng tsa se:

1. congenital "shortened metso";

2. paraesophageal hernia, eo ho eona karolo ea mala hangata teng ka lehlakoreng la metso ea;

3. hiatal hernia Sliding, moo ba cardiac metso sebakeng mala ka ea huloa ka letsoele cavity.

Paraesophageal hernia, e le Sliding ka 'na ba congenital kapa fumana, empa e le ka seoelo ho feta e fumanweng ka hernia congenital. Ka batho ba ileng ba fihla lilemong tse 40, ke tse ling tse ngata ho tloaelehile hore batho ba fumana hernia. Le ea bohlokoa haholo ke lilemo involution lisele, ea isang ho katoloso le fokolisang tsa qalang esophageal dikgokelo tse busetsang tjhelete diaphragm le metso.

Sesosa o tloaelehileng haholo oa herniation ho na le mabaka a mabeli. E mong -pulsatsionny Ntlha e oo hernia sa thehoa ka lebaka la ho baka keketseho e ka intra-mpeng khatello ea (ho ikoetlisa boima, flatulence, ho ja ho tlōla, ho ima, kamehla apara mabanta thata). Ntho e 'ngoe - traction e amanang le gipermotorikoy metso e bakoang ke ho hlatsa khafetsa.

A ea makhaola-khang seabo tlhomamaisa ho fumanoe litšoantšiso X-ray hlahloba. Diaphragmatic hernia arotsoe ka bophara nyenyane (3 cm,), seaplane (3 ho 8 cm,) 'me o moholo (tse fetang 8 cm,).

Diaphragmatic hernia ho tšoaroa ka eona le mekhoa mekhoa e tloaetsoeng ba ke ke ba hlahisa sephetho lakatsa, ho e molemo ka ho fetisisa tšoaroa ngaka e ka.