Open AccessDiaphragmatic hernia: formation mechanisms, clinical picture, treatment tactics
Author(s) -
Н. Б. Губергріц,
N. V. Byelyayeva,
A. Ye. Klochkov,
Г. М. Лукашевич,
П. Г. Фоменко,
A. V. Yur’eva
Publication year - 2019
Publication title -
vestnik kluba pankreatologov
Language(s) - English
Resource type - Journals
ISSN - 2077-5067
DOI - 10.33149/vkp.2019.03.10
Subject(s) - medicine , diaphragmatic hernia , hiatal hernia , diaphragmatic breathing , pathogenesis , hernia , etiology , pantoprazole , anesthesia , surgery , cardiology , disease , pathology , reflux , alternative medicine , omeprazole
The article presents current data on etiology, pathogenesis of diaphragmatic hernia. Types of diaphragmatic hernia are described in detail, namely: axial, paraesophageal, mixed; transient and fixed. Pathogenesis of the formation of hiatal hernia includes: failure of the connective tissue structures involved in the formation of the esophago-gastric junction; significant increase in intra-abdominal pressure; increase in motor activity of the esophagus (hypermotor dyskinesia). Clinical manifestations and peculiarities of pain, including pseudo-coronary pain, differential diagnosis, are described. Recommendations for non-drug treatment, including lifestyle and nutritional changes, are presented. Particular attention is paid to pantoprazole as a means of choice for therapy of patients. Advantages of pantoprazole as compared with other proton pump inhibitors are presented: selectivity of action depending on pH, absence of “decussation” with the metabolism of other drugs, efficacy, duration of acid suppressive action, safety, favorable pharmacoeconomic characteristics.