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目的 加深对伴有脊柱后突的不可复性食管裂孔疝影像表现的认识 ,并探讨此类食管裂孔疝形成的机制。材料与方法对照分析 8例经钡餐造影确诊的伴有脊柱后突的不可复性食管裂孔疝的胸片与CT、MR影像表现。结果 8例均为老年人 ,以女性居多。胸片与CT、MR影像表现均见疝囊在心脏之后呈肿块状 ,内含气体或气 液面。并有食管裂孔增宽、膈肌后份变平、后肋膈角变浅、贲门位于膈上而食管不短 ;均见脊柱胸腰段后突 ,该水平胸廓前后径增大。胸片初诊半数误诊。结论 脊柱后突的老年人发现心后肿块要警惕食管裂孔疝的可能。这类不可复性食管裂孔疝有可能是由脊柱后突牵拉所致
Objective To deepen the understanding of the manifestations of refractory esophageal hiatal herniation associated with kyphosis and to explore the mechanism of such hiatal hernia formation. Materials and Methods: 8 cases of non-recidivalent esophageal hiatal hernia diagnosed by barium meal confirmed by X-ray and CT, MR imaging. Results 8 cases were elderly, mostly women. Chest radiographs and CT, MR imaging showed hernia sac in the heart after a mass, containing gas or gas-liquid surface. And the widening of the esophageal foramen, phrenic flattened after the back of the diaphragm angle shallow, the cardia is located on the diaphragm and the esophagus is not short; all see the thoracolumbar kyphosis, the horizontal thoracic anteroposterior diameter increased. First half of chest X-ray misdiagnosis. Conclusion The elderly patients with kyphosis find the possibility of posterior hysterocele to be wary of esophageal hiatal hernia. This type of refractory esophageal hiatal hernia may be due to the traction of the posterior column