Sikhuluma nge-hernia lapho isitho sishiya ingxenye ethile yomgodi ovame ukuqukethe, sidlula endaweni yemvelo.

Uma une i-hernia yokuzalwa, yisisu esikhuphuka ngokwengxenye ngokuvula okuncane okubizwa nge- “esophageal hiatus”, esisethangeni, umsipha wokuphefumula ohlukanisa umgodi wesifuba esiswini.

I-hiatus imvamisa ivumela i-esophagus (= ithubhu exhuma umlomo nesisu) ukuthi idlule kwisifafazi ukuletha ukudla esiswini. Uma ikhula, lokhu kuvuleka kungavumela ingxenye yesisu noma isisu sonke, noma ezinye izitho esiswini, ukuthi zikhuphuke.

Kunezinhlobo ezimbili eziyinhloko ze-hiatus hernia:

• La ngokuhambisa i-hernia noma thayipha I, emele cishe ama-85 kuye kuma-90% wamacala.

  Ingxenye engenhla yesisu, okuyindlela ehlangana phakathi kwesimungulu nesisu ebizwa nge- “cardia”, inyukela esifubeni, idale ukusha okuhambisana ne-reflux yegastroesophageal.

• La i-hernia ye-paraesophageal noma ukugoqa noma ukuthayipha II. Ukuhlangana phakathi komqala nesisu kuhlala endaweni engezansi kwesivalo, kepha ingxenye enkulu yesisu "iyagingqeka" futhi idlule kwi-hiatus yesophageal, yakhe uhlobo lwephakethe. Le hernia imvamisa ayibangeli zimpawu, kepha kwezinye izimo ingaba yimbi.

Kukhona nezinye izinhlobo ezimbili ze-hiatus hernia, ezingavamile kakhulu, okuyizinto ezihlukile ze-hernia ye-paraesophageal hernia:

• Thayipha III noma uxubile, lapho i-hernia eslayidayo ne-paraesophageal hernia ihlangana.
• Uhlobo IV, oluhambisana nehernia yesisu sonke kwesinye isikhathi oluhambisana namanye ama-viscera (amathumbu, ubende, ikholoni, amanyikwe…).

Izinhlobo II, III no-IV zihlangene zenza u-10 kuye ku-15% wamacala we-hiatus hernia.

Ubani othintekayo?

Ngokwezifundo, abantu abadala abangama-20 kuya ku-60% bane-hiatus hernia ngesikhathi esithile empilweni yabo. Imvamisa ye-hiatus hernias iyanda ngeminyaka: ithinta abantu abayi-10% abangaphansi kweminyaka engama-40 kuya kwabangu-70% babantu abangaphezu kuka-60¹.

Kodwa-ke, kunzima ukuthola ukusabalala okunembile ngoba ama-hiatus hernias amaningi awazazi izimpawu (= awazibangeli izimpawu) ngakho-ke aya kutholakala.

Izimbangela zalesi sifo

Izimbangela eziqondile ze-hiatus hernia azikhonjwanga ngokucacile.

Kwezinye izimo, i-hernia izalwa naso, okungukuthi, ikhona kusukela ekuzalweni. Kungenxa yalokho ukungahambisani kahle kwe-hiatus ebanzi kakhulu, noma kuyo yonke i-diaphragm engavaliwe kahle.

Kodwa-ke, iningi lalezi hernias livela ngesikhathi sokuphila futhi livame kakhulu kubantu asebekhulile. Ukunwebeka nokuqina kwesifafazwe kubonakala kwehla ngokuguga, kanti i-hiatus ivame ukwanda, ivumele isisu ukuthi sikhuphuke kalula. Ngaphezu kwalokho, izakhiwo ezinamathisela i-cardia (= i-gastroesophageal junction) kwi-diaphragm, futhi egcina isisu sikhona, nazo ziyawohloka ngokuguga.

Ezinye izinto ezinobungozi, njengokukhuluphala noma ukukhulelwa, nazo zingahlotshaniswa ne-hiatus hernia.

Inkambo kanye nezinkinga ezingenzeka

La beya hiatus hernia ikakhulu kubangela isilungulela, kepha imvamisa akusikho okubi.

La ukuqaqa i-hiatus hernia ivame ukuba ne-asymptomatic kepha ivame ukwanda ngosayizi ngokuhamba kwesikhathi. Ingahlotshaniswa nezinkinga ezisongela impilo, njenge:

• Ubunzima bokuphefumula, uma i-hernia inkulu.
• Ukopha okuqhubekayo okuqhubekayo kwesinye isikhathi kufinyelela ekubangeleni i-anemia ngenxa yokuntuleka kwensimbi.
• Ukudonswa yisisu (= i-gastric volvulus) ebanga ubuhlungu obunodlame futhi kwesinye isikhathi i-necrosis (= ukufa) kwengxenye ye-hernia ekuqothulweni, incishwe umoya-mpilo. Ulwelwesi lwesisu noma umphimbo nalo lungadabula, lubangele ukopha kokugaya ukudla. Ngemuva kwalokho kufanele singenelele ngokuphuthumayo futhi sihlinzeke esigulini, impilo yaso engaba sengozini.