Timalankhula za chophukacho pamene chiwalo chimachoka pang'onopang'ono pabowo lomwe nthawi zambiri chimakhala nacho, ndikudutsa m'malo achilengedwe.

Ngati muli ndi chophukacho, ndi m'mimba yomwe imakwera pang'onopang'ono kudzera mumsewu waung'ono wotchedwa "esophageal hiatus", yomwe ili mu diaphragm, minofu yopuma yomwe imalekanitsa chifuwa cha thoracic kuchokera pamimba.

Kupuma nthawi zambiri kumapangitsa kuti mmero (= chubu chomwe chimalumikiza pakamwa ndi m'mimba) kudutsa pa diaphragm kubweretsa chakudya kumimba. Ngati chakula, kutsegula kumeneku kungalole kuti mbali ya mimba kapena mimba yonse, kapena ziwalo zina za m’mimba zituluke.

Pali mitundu iwiri ikuluikulu ya hiatus chophukacho:

• La kutsetsereka chophukacho kapena lembani I, yomwe imayimira pafupifupi 85 mpaka 90% ya milandu.

  Kumtunda kwa m'mimba, komwe kumadutsana pakati pa mmero ndi m'mimba yotchedwa "cardia", kumapita m'chifuwa, kumayambitsa kutentha komwe kumayenderana ndi gastroesophageal reflux.

• La nthenda ya paraesophageal kapena kugudubuza kapena mtundu II. Kulumikizana kwapakati pa mmero ndi m'mimba kumakhalabe m'munsi mwa diaphragm, koma gawo lalikulu la m'mimba "amagudubuza" ndikudutsa kummero, ndikupanga thumba. Chophukacho nthawi zambiri sichimayambitsa zizindikiro, koma nthawi zina chikhoza kukhala chachikulu.

Palinso mitundu ina iwiri ya hiatus hernia, yocheperako, yomwe ili yosiyana kwambiri ndi chophukacho cha paraesophageal:

• Mtundu wa III kapena wosakanizidwa, pamene chophukacho chotsetsereka ndi chophukacho cha paraesophageal chimagwirizana.
• Mtundu IV, womwe umafanana ndi chophukacho cham'mimba chonse nthawi zina umatsagana ndi viscera ina (matumbo, ndulu, m'matumbo, kapamba ...).

Mitundu II, III ndi IV palimodzi imapanga 10 mpaka 15% ya milandu ya hiatus hernia.

Ndani akukhudzidwa?

Malinga ndi kafukufuku, 20 mpaka 60% ya akuluakulu amakhala ndi hiatus hernia nthawi ina ya moyo wawo. Kuchuluka kwa hiatus hernias kumawonjezeka ndi zaka: zimakhudza 10% ya anthu ochepera zaka 40 mpaka 70% ya anthu oposa 60.¹.

Komabe, n'kovuta kupeza kufalikira kolondola chifukwa ambiri hiatus hernias ndi asymptomatic (= samayambitsa zizindikiro) choncho samadziwika.

Zimayambitsa matenda

Zomwe zimayambitsa hiatus hernia sizidziwika bwino.

Nthawi zina, chophukacho ndi kobadwa nako, ndiko kuti, alipo kuyambira kubadwa. Zimachitika chifukwa cha kusokonekera kwa hiatus komwe kuli kwakukulu kwambiri, kapena kwa diaphragm yonse yomwe siyimatsekeka bwino.

Komabe, ambiri mwa hernias amawonekera pa moyo ndipo amapezeka kwambiri mwa okalamba. Kutanuka ndi kuuma kwa diaphragm kumawoneka kuti kumachepa ndi ukalamba, ndipo kuima kumakula, zomwe zimapangitsa kuti mimba ikwere mosavuta. Kuonjezera apo, zomwe zimagwirizanitsa ndi cardia (= gastroesophageal junction) ku diaphragm, zomwe zimasunga mimba m'malo mwake, zimawonongeka ndi zaka.

Zinthu zina zowopsa, monga kunenepa kwambiri kapena kukhala ndi pakati, zimathanso kulumikizidwa ndi hiatus hernia.

Zochitika komanso zovuta

La kutsetsereka hiatus chophukacho makamaka kumayambitsa kutentha pamtima, koma nthawi zambiri sikumakhala koopsa.

La kugudubuza hiatus chophukacho nthawi zambiri amakhala asymptomatic koma amakula kukula pakapita nthawi. Zitha kugwirizanitsidwa ndi zovuta zomwe zingawononge moyo, monga:

• Kupuma kovuta, ngati chophukacho ndi chachikulu.
• Kutuluka magazi pang'ono kosalekeza nthawi zina kumafika mpaka kuchititsa kuchepa kwa magazi chifukwa chosowa ayironi.
• Kuphulika kwa m'mimba (= chapamimba volvulus) chomwe chimayambitsa kupweteka kwamphamvu ndipo nthawi zina necrosis (= imfa) ya gawo la chophukacho mu torsion, wopanda mpweya. Mzere wa m'mimba kapena kum'mero ​​ungathenso kung'ambika, zomwe zimayambitsa kutuluka kwa magazi m'mimba. Kenako tiyenera kulowererapo mwachangu ndikuchita opaleshoni wodwalayo, yemwe moyo wake ungakhale pachiwopsezo.