Hernia Hiatal

Question 1

Encontramos esta enfermedad en un:

Answer 1

50% de las personas con mas de 50 años

Question 2

La probabilidad de que esta patología ocurra aumenta con:

Answer 2

la edad

Question 3

Esta patología es mas común en:

Answer 3

Mujeres

Question 4

Esta enfermedad esta asociada a:

Answer 4

(1) Sigmoid diverticulosis (25% of cases)
(2) Esophagitis (25% of cases)
(3) Duodenal ulcers (20% of cases)
(4) Gallstones (18% of cases)

Question 5

Cuales son los dos tipos de hernias hiatales?

Answer 5

Sliding hernia (99%) and paraeshopageal hernia (1%)

Question 6

Como es la herniacion en ambas hernias?

Answer 6

En la hernia deslizante: Herniation of proximal stomach into thoracic cavity through the diaphragmatic esophageal hiatus.

En la hernia paraesofagica: Gastroesophageal junction remains at the level of the diaphragm and Part of the stomach bulges into the thoracic cavity.

Question 7

Hallazgos clínicos de la hernia deslizante:

Answer 7

(1) Heartburn
(2) Nocturnal epigastric distress from acid reflux
(3) Hematemesis (vomiting blood)
(4) Ulceration, stricture
(5) Bowel sounds heard over left lung base

Question 8

Tratamiento de la hernia delizante:

Answer 8

(1) Nonpharmacologic
(a) Reduce intake of foods/drugs that decrease lower esophageal sphincter tone
• Examples—coffee, chocolate, calcium channel blockers
(b) Avoid eating large quantities of food
(c) Sleep with head of the bed elevated
(2) Pharmacologic
(a) H2 antagonists
(b) Proton pump inhibitors
(c) Prokinetic agents
(3) Surgery if indicated