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目的探讨小儿食管裂孔疝的X线诊断。方法本组28例患儿均经X线钡剂造影发现食管裂孔疝。结果20例可见贲门、胃底进入纵隔呈葫芦状阴影,食管胃环位于膈上,食管胃角增大变钝,其中4例患儿显示合并短食管畸形(其中2例位于右侧胸腔),1例位于左侧胸腔及合并短食管畸形,胃粘膜不规则、胃扭转、胃食管反流并不明显,诊断为旁疝。2例贲门位置不能确定,但可见胃及部分肠管同时疝入纵隔,考虑为混合型食管裂孔疝。结论食管裂孔疝是引起婴幼儿胃食管反流的主要病变。X线检查可以明确不同类型的诊断,为临床治疗提供重要依据。
Objective To investigate the X-ray diagnosis of hiatal hernia in children. Methods The group of 28 children were diagnosed by esophageal hiatal herography by X-ray barium. Results Gastric cardia was found in 20 cases, gourd-shaped shadow appeared in the mediastinum, esophagogastric ring located on the diaphragm, esophagogastric angle increased dull, 4 cases showed malformation of short esophagus (2 of them were located on the right chest) One case was located on the left side of the chest and the merger of short esophageal malformations, irregular gastric mucosa, gastric reverse, gastroesophageal reflux is not obvious, diagnosis of parahiatic hernia. 2 cases of cardiac position can not be determined, but we can see the stomach and part of the intestine at the same time hernia into the mediastinum, consider a mixed esophageal hiatal hernia. Conclusion Hiatal hiatal hernia is the main cause of gastroesophageal reflux in infants. X-ray examination can clear different types of diagnosis, provide an important basis for clinical treatment.