Watson Thomas J., Moritz Troy
UPMC -- Pinnacle Harrisburg, PA
UPMC Pinnacle
There are four types of hiatal hernias. However, the sliding hiatal hernia (type 1) is the most common and accounts for up to 95% of all hiatal hernias. Type 1 hiatal hernias solely involve "sliding" of the gastroesophageal (GE) junction into the thoracic cavity. Type 2 to 4 hiatal hernias are true paraesophageal hernias (PEHs) and are classified based upon on location of the GE junction as well as what has herniated into the thoracic cavity. A type 2 hiatal hernia has a GE junction in the normal anatomic position, but a portion of the stomach, most often the fundus, has herniated through the hiatus. Type 3, like type 2, have a portion of the stomach that has herniated through the hiatus, but also have an abnormal position of the GE junction in the thoracic cavity. Type 4 has an abnormal GE junction position like type 1 and 3. However, another organ, most often a portion of the colon, has herniated into the thoracic cavity.
食管裂孔疝有四种类型。然而,滑动型食管裂孔疝(1型)最为常见,占所有食管裂孔疝的95%。1型食管裂孔疝仅涉及胃食管(GE)交界处“滑动”进入胸腔。2至4型食管裂孔疝是真正的食管旁疝(PEH),根据GE交界处的位置以及疝入胸腔的内容物进行分类。2型食管裂孔疝的GE交界处位于正常解剖位置,但一部分胃,最常见的是胃底,通过裂孔疝出。3型与2型一样,有一部分胃通过裂孔疝出,但GE交界处也位于胸腔的异常位置。4型的GE交界处位置与1型和3型一样异常。然而,另一个器官,最常见的是一部分结肠,疝入了胸腔。