Antral

Anatomically expressed valve in that area there. The lower part of esophagus and esophageal-gastric connection held in esophageal opening frenoezofagialnoy ligament. It consists of sheets of transverse abdominal fascia and the intrathoracic fascia. Aperture-esophageal ligament is attached around the circumference of the esophagus to the diaphragmatic part of it. Attaching the ligament is a fairly wide area - from 3 to 5 cm in length. Upper leaf frenoezofagealnoy ligament usually attached to 3 centimeters above the transition of squamous epithelium into a cylindrical. Lower leaf binder on 1,6 cm below the compound. Attaching the membrane to the wall of the esophagus through a very thin trabecular bridges connecting to the muscular layer of the esophagus. This attachment provides a dynamic interaction between the esophagus and the diaphragm during the act of swallowing and breathing, when the abdominal esophagus lengthened or shortened.

Zamykatelny mechanism of the esophagus. Anatomical brand viagra online sphincter expressed in cardia not. It was established that the diaphragm and its legs are not involved in the closure of the cardia. Reflux of gastric contents into the esophagus is not desirable, since the epithelium of the esophagus is extremely sensitive to the digestive action of acidic gastric juice. Normally, the pressure seemed to predispose to its occurrence, because the stomach is above atmospheric pressure, and in the esophagus - below. For the first time works Ingeifinger Code and it was proved that in the lower segment of esophagus 2-3 cm above the diaphragm there is a zone of high pressure. When measuring the pressure tank, it was shown that the pressure in this zone is always higher than in the stomach and in the upper esophagus, regardless of body position and breathing cycle. This department has a pronounced motor function, which convincingly proved the physiological pharmacological and radiological studies. This part of the esophagus acts as an esophageal-gastric sphincter, closure is made in full on the entire site, rather than as a reduction of the individual segments. When approaching peristaltic wave it completely relaxes.

There are several variants of esophageal-gastric hernia of the diaphragm hole. BV Petrovsky proposed the following classification:

I. Sliding (Axial) hiatal hernia.

No shortening of the esophagus. With the shortening of the esophagus.

* Cardiac;
* Kardiofundalnaya;
* Subtotal gastric;
* Total stomach.

II. Paraesophageal hernia.

* Fundal;
* Antral;
* E.;
* Gastrointestinal;
* Gland.

One should distinguish between:

1. Congenital "short esophagus with intrathoracic gastric location.

2. Paraesophageal hernia, where part of the stomach is being introduced at the side of a normally located esophagus.

3. Sliding hiatal hernia, where the esophagus with the cardiac portion of stomach is pulled into the chest cavity.

Sliding hernia is so called because the posterior-upper part of the cardiac portion of stomach is not covered by peritoneum and the displacement herniation into the mediastinum slips on the type of going out of the bladder or the cecum with inguinal hernia. With paraesophageal hernia organ or part of the abdominal organs pass into the left of the oesophageal hiatus of the esophagus and gastric cardia remains fixed in place. Paraesophageal hernia, as well as moving, can be congenital or acquired, but congenital hernias occur much less frequently than acquired. Acquired hernias are more common in the age of 40. Has a value of age involution of tissues which leads to increased esophageal opening, weakening of the esophagus to the diaphragm.

The immediate causes of gryzheobrazovaniya may be two factors. Pulsation factor - the increase in cialis without prescription intra-abdominal pressure in severe physical exertion, overeating, flatulence, pregnancy, and the constant wearing tight belts. Traktsioiny factor - gipermotorika esophagus associated with frequent vomiting, and disorders of the nervous regulation of motility.

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