HIATAL HERNIA

ALEJANDRO VILLAGRANA ALVAREZENGLISH VI

TEACHER: MARTHA GONZÁLEZ REYES

TYPE OF PATIENTS

DIAPHRAGM

• Tissue sinewy muscle

• Form of two copulations

• Points of insertion: xiphoid process, costal edges chest wall, ends of the 11° and 12° ribs, posterior abdominal wall, lumbar vertebrae

• Innervated by the phrenic nerve

• Irrigated by: inferior and superior phrenic arteries, artery intercostal, artery pericardiophrenic.

• Holes: aortic hiatus (aorta, vena azygos and hemiazygos, thoracic duct), vena cava inferior (phrenic nerve), esophageal hiatus.

ESOPHAGUS

• Cervical: belongs to the visceral compartment of the neck

•Thoracic: related to hockey sticks azygos vein and aorta, the thoracic duct, left atrium of the heart

•Abdominal: left lobe of the liver and lesser omentum.

•Peristalsis

•Primary: triggered by swallowing

•Secondary: initiated by the parietal distention

•Tertiary: spontaneous and propulsive

•Lower sphincter: smooth muscle fibers, pressure of 15-30 mmHg.

CAUSES HIATAL HERNIA

• Aging

• Chronic cough

• Constipation

• Obesity

• Heavy lifting

• Stress

• Smoking

• Previous surgery of stomach or esophagus

SYMPTOMATOLOGY• Reflux symptoms

• Chest pain

• Difficulty swallowing

• Regurgitation

• Belching

• Cough

COMPLICATIONS• Strangulation of the portion of the stomach that has slipped

• Broncoaspiration

• Changes in the structure of the esophageal Wall

• Barrett’s esophagus

• Esophageal cancer

CONFIRMATION OF DIAGNOSIS• Radiography contrast barium

• pH test

• Manometry

• Endoscopy

GASTROSCOPY• The test is performed in 15-30 minutes

• Is recommended acompanied

• Not require any medication special

•Not food or water for 6-8 hours prior

•

•CONTRAINDICATIONS

• Patients with intestinal diseases that may worsen with test performance

• Unestable or seriously ill patients with significant hypotension

• Severe cervical scoliosos

• Seriously bleeding problems

• Severe arrhythmias

TREATMENT • Food diet devoid of irritants and in small amounts

• Proton-pump inhibitor

• Antagonists histamine – 2

• Prokinectics

• Nissen fundoplication

PROGNOSIS Generally is favorable

when control of symptoms with dietary

pharmacological and hygienic measures

unfortunately 20% of patients it becomes a

chronic disease.

There is no better way to love ourselves that being aware of

our health, therefore recommend constant

consultations with our trusted physician to be aware

of our health.

THANK YOU FOR YOUR ATTENTION