The hernia diafragmalnaja.
Anomaly of development (exeption traumati hernias make). Depending on loalization of a hernial gate it is aepted to distinguish three kinds diafragmalnyh hernias: hernias atually diaphragms hernias pishhevodnogo apertures of a diaphragm hernias of a forward department of a diaphragm.
a linial piture. At hernias atually diaphragms attributes of disease appear quite often at the first olok and days of a life. Attaks tsianoza, a short wind, sometimes ough are marked. The attak tsianoza an be short-term, disappears or dereases at perevorahivanii the hild for the amazed party. Displaement in a avity of a thorax of intestinal loops auses timpanihesky a sound during perkussii, alternating with sites prituplenija. Borders of heart are displaed aside, opposite to a hernia more often. During auskultatsii on the amazed party it is possible to hear intestinal peristaltiku. If the hild does not die in the period newborn, with the years he gradually adapts for existene of a hernia, and attaks tsianoza repeat less often. Children lag behind in physial development, in them pneumonias are frequent. Compliation - infringement of a hernia at whih attributes of respiratory insuffiieny and intestinal impassability are ombined an develop.
at hernias pishhevodnogo apertures symptoms appear usually from seond half-year of a life. Are harateristi persistent vomiting, it is frequent with an impurity of blood, an anemia, presene of blood in kale owing to arisen -uler ezofagita and a gastritis. Pains in the field of a brest and rumbling in the stomah, heard on distane are harateristi also. Deviations fizikalnyh data find out in mezhlopatohnoj areas.
hernias of a forward department of a diaphragm quite often proeed bessimptomno. Only at signifiant vypjahivanii domes of a diaphragm are possible omplaints to pains in a stomah and breasts, a short wind. At external examination it is possible to find out deformation of a thorax in suh patients in the form of Kiel and in rare ases of a deviation fizikalnyh data parasternalno on the right.
the Diagnosis. Reognition diafragmalnoj hernias is based on omparison of the anamnesis and omplaints to data of objetive inspetion. Finally onfirms the diagnosis radiologial researh.