Isu tinotaura nezve hernia kana nhengo ikabuda zvishoma mugomba rinowanzo kuve naro, ichipfuura nepaburi rechisikigo.

Kana iwe une hiatal hernia, idumbu rinokwira muchikamu kuburikidza nekaburi kadiki kanonzi "esophageal hiatus", iri mu diaphragm, mhasuru yekufema inoparadzanisa gumbo rechipfuva kubva mudumbu.

Iyo hiatus inowanzobvumira esophagus (= chubhu inobatanidza muromo nedumbu) kupfuura nepadiaphragm kuunza chikafu mudumbu. Kana rikakura, buri iri rinogona kubvumira chikamu chedumbu kana dumbu rose, kana dzimwe nhengo dziri mudumbu, kuti dzibude.

Kune marudzi maviri makuru ehiatus hernia:

• La sliding hernia kana kunyora I, inomiririra anenge 85 kusvika 90% yematambudziko.

  Chikamu chepamusoro chedumbu, chinova chinobatana pakati pegurokuro nedumbu chinonzi "cardia", chinokwira muchipfuva, chinokonzera kupisa kunoenderana negastroesophageal reflux.

• La paraesophageal hernia kana kukunguruka kana kunyora II. Kusangana pakati pegurokuro nedumbu kunoramba kuri panzvimbo pazasi pe diaphragm, asi chikamu chikuru chedumbu "chinomonereka" pamusoro uye chinopfuura nepagurokuro yegurokuro, ichigadzira imwe homwe. Iyi hernia kazhinji haikonzeri zviratidzo, asi mune dzimwe nguva inogona kunge yakakomba.

Kunewo mamwe marudzi maviri ehiatus hernia, asinganyanyi kuwanda, ayo ari musiyano weparaesophageal hernia:

• Type III kana kusanganiswa, panotsvedza hernia neparaesophageal hernia pazvasangana.
• Type IV, inoenderana hernia yemudumbu yese dzimwe nguva ichiperekedzwa neimwe viscera (ura, spleen, colon, pancreas…).

Mhando II, III uye IV pamwe chete dzinotora gumi kusvika 10% yezviitiko zve hiatus hernia.

Ndiani anobatwa?

Maererano nezvidzidzo, 20 kusvika 60% yevanhu vakuru vane hiatus hernia pane imwe nguva muupenyu hwavo. Kuwanda kwehiatus hernias kunowedzera nezera: inobata 10% yevanhu vari pasi pemakore makumi mana uye kusvika ku40% yevanhu vanopfuura makumi matanhatu.¹.

Nekudaro, zvakaoma kuwana kupararira kwakaringana nekuti akawanda hiatus hernias asymptomatic (= haakonzerese zviratidzo) uye saka anoenda asina kuongororwa.

Zvinokonzera chirwere

Zvikonzero chaizvo zvehiatus hernia hazvizivikanwe zvakajeka.

Mune zvimwe zviitiko, hernia inoberekwa, ndiko kuti, iripo kubva pakuberekwa. Zvinobva zvakonzerwa neanomaly yehiatus iyo yakakura zvakanyanya, kana ye diaphragm yese isina kuvharika zvakanaka.

Zvisinei, iyo yakawanda yeiyi hernias inoonekwa munguva yehupenyu uye inowanikwa kune vanhu vakwegura. Kunaka uye kuoma kwe diaphragm kunoratidzika kunge kuderera nekukura, uye hiatus inowanzowedzera, zvichiita kuti dumbu risimuke nyore nyore. Mukuwedzera, zvimiro zvinobatanidza cardia (= gastroesophageal junction) kune diaphragm, uye iyo inochengetedza dumbu panzvimbo, zvakare inoderera nezera.

Dzimwe njodzi dzinokonzeresa, dzakadai kufutisa kana kubata pamuviri, dzinogonawo kusanganisirwa nehiatus hernia.

Nzira uye zvinogona kuitika

La sliding hiatus hernia zvinonyanya kukonzera chirungurira, asi kazhinji kazhinji hachisi chakakomba.

La rolling hiatus hernia inowanzoita asymptomatic asi inowanzo wedzera saizi nekufamba kwenguva. Inogona kusanganisirwa nematambudziko anotyisidzira hupenyu, akadai se:

• Kunetseka kwekufema, kana hernia yakakura.
• Kubuda ropa kudiki kunoramba kuchienderera dzimwe nguva kunoenda kusvika pakukonzera anemia kubva mukushaikwa kwesimbi.
• Kutsemuka kwemudumbu (= gastric volvulus) kunokonzera marwadzo echisimba uye dzimwe nguva necrosis (= kufa) kwechikamu chehernia mukuzununguka, kunyimwa oxygen. Rudzi rwedumbu kana esophagus runogonawo kubvaruka, zvichikonzera kubuda ropa mukugaya. Tinofanira ipapo kupindira nekuchimbidza uye kuvhiya murwere, ane hupenyu hungave munjodzi.