Phrenic hernia

Description:

Hernia of an esophageal opening of a diaphragm or phrenic hernia arises if through an esophageal opening of a diaphragm (an opening through which the gullet from a chest cavity gets into belly) a belly part of a gullet, a part of a stomach or a belly part of a gullet together with a part of a stomach is displaced in a chest cavity. Through an esophageal opening of a diaphragm in a chest cavity also other bodies located in a stomach cavity can sometimes be displaced.

Symptoms of Phrenic hernia:

At the beginning of a disease the shift of bodies of a cavity of a stomach in a chest cavity arises periodically, under the influence of exercise stresses, cough, vomiting, an overeating, etc. Then such loss becomes more frequent or constant.

Most often hernia axial or sliding meets. At the same time in an esophageal opening of a diaphragm a belly part of a gullet or final department of a gullet with a part of a stomach drops out.

The sliding hernias of an esophageal opening of a diaphragm can not be shown by complaints if the lower sphincter of a gullet functions normally. But, often, at this state function of a sphincter is broken and there is a gastroesophagal reflux – throwing of contents of a stomach in a gullet. Eventually under the influence of aggressive gastric contents there is an inflammatory process in a lower part of a gullet – an esophagitis. The patient has complaints to the heartburn after food amplifying in horizontal position at physical efforts. There are pains after food. Pains can have various character, give to a breast, to the area of heart, a shovel, a neck, a mandible. Sometimes pains can arise only in a certain position of a body.

If in a chest cavity there is a part of a stomach, such hernia is called paraezofagealny (periesophagal). At this hernia of pain arise more often, give to the lower part of a breast, a shoulder, the left hand and, sometimes, remind the pains arising at stenocardia. These pains often begin in a dorsal decubitus. The patient can complain of gastric flatulence, feeling of a foreign body in an upper part of a stomach.

The reflux esophagitis happens a complication of hernia of an esophageal opening of a diaphragm most often, but the round ulcer of a gullet at which long current in turn there can be a cicatricial stenosis (narrowing) of a gullet can develop. Acute and chronic bleeding from a gullet, perforation of a gullet or a strangulation of a hernia in an esophageal opening of a diaphragm meet.

The diagnosis of hernia of an esophageal opening of a diaphragm is established at a X-ray analysis. Often happens rather usual roentgenoscopy of a gullet and a stomach by means of contrasting by barium. For specification of the diagnosis carry out an ezofagogasroskopiya.

Reasons of Phrenic hernia:

The increased elasticity of fabrics limiting esophageal opening of a diaphragm, a sheaf between a diaphragm and a gullet, one of diaphragm legs happens the reason of phrenic hernia. The increased elasticity of an opening of a diaphragm can be inborn. Sometimes anomaly of development - a so-called "short gullet with a chest stomach" meets, but more often hernia arises during the patient's life under the influence of the conditions promoting increase in intra belly pressure. It is hard physical work, obesity, ascites (accumulation of liquid in an abdominal cavity), endocrine diseases. Sometimes leads pregnancy to hernia of an esophageal opening of a diaphragm. Easing and thinning of sheaves and connecting fabric matters with age.

Treatment of Phrenic hernia:

The diet with fractional food in the small portions, treatment of locks is appointed. The physiotherapy exercises are surely used. Performance of certain exercises allows to avoid stomach shift. Drugs for reduction of gastric secretion and decrease in acid aggression of gastric contents, normalization of diskineziya of digestive tract are used. Sometimes there is a need for operational treatment. Emergence of complications of hernia of an esophageal opening of a diaphragm most often is the indication for purpose of operational treatment.