Approaches to the diagnosis and grading of hiatal hernia
Approaches to the diagnosis and grading of hiatal hernia
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DOI：
10.1016/j.bpg.2007.12.007
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发表时间：
2008-01-01
影响因子：
3.2
通讯作者：
Pandolfino, John E.
中科院分区：
文献类型：
--
作者：
Kahrilas, Peter J.;Kim, Hyon C.;Pandolfino, John E.
食管裂孔疝是指腹腔的组成部分，最常见的是胃，通过食管裂孔疝入纵隔的情况。最常见的类型（I型或滑动型裂孔疝）与膈食管膜松弛和贲门疝有关。当轴向跨度大于2cm时，滑动型食管裂孔疝很容易通过吞钡造影、内窥镜检查或测压来诊断。然而，食管胃交界处的移动性使得内窥镜或X线检查无法可靠地检测到更细微的破坏。检测下食管括约肌和小腿隔膜之间较小程度的轴向分离只能通过高分辨率测压法可靠地完成，这种技术允许真实的时间定位这些食管胃连接部分，而没有吞咽或扩张相关的伪影。
Hiatus hernia refers to conditions in which elements of the abdominal cavity, most commonly the stomach, herniate through the oesophageal hiatus into the mediastinum. With the most common type (type I or sliding hiatus hernia) this is associated with laxity of the phrenooesophageal membrane and the gastric cardia herniates. Sliding hiatus hernia is readily diagnosed by barium swallow radiography, endoscopy, or manometry when greater than 2 cm in axial span. However, the mobility of the oesophagogastric junction precludes the reliable detection of more subtle disruption by endoscopy or radiography. Detecting lesser degrees of axial separation between the lower oesophageal sphincter and crural diaphragm can only be reliably accomplished with high-resolution manometry, a technique that permits real time localization of these oesophagogastric junction components without swallow or distention related artefact.