Middle rupture: cause, diagnosis, symptoms, treatment and recovery

In the soft tissues, such as the weak parts (connective tissue muscle plates, membranes, veins, fascia, etc.) of your body, a weakness can occur because of excessive force or pressure exerted from the inside or outside or through wear . There is a crack in the internal protective layers and therefore tissues can pile out. This often leads to pain, mobility loss and other medical complications.

Known fractures are those in the lower abdomen: eg the fracture of the groin, umbilical fracture, bowel fracture, thigh fracture and abdominal fracture. A rupture in the upper abdomen is somewhat rarer; In addition, such a break does not always cause complaints. Thus a break in the upper abdomen is less known. The (by far) most common fracture in the upper tissues is the medial rupture or diaphragm failure...

What is a median rupture?

When you eat something, your food passes through your esophagus. The esophagus reaches your stomach through an opening in your diaphragm. This opening is also called 'hiatus' or 'hiatus esophageal'. Your diaphragm is a dome-shaped "muscle plate" that causes your thoracic cavity to be separated from your abdominal cavity. In your diaphragm is not only an opening for your esophagus, but also for your veins and nerves.

If a natural opening in the diaphragm is stretched or torn-and thus larger than usual, one is talking about a medial rupture. The same applies when an unnatural opening has occurred (ie in a place where no opening should be seen). The larger the opening or the "gap gate", the greater the chance of something popping out and a median rupture will be accompanied by complaints, symptoms and complications.

Symptoms of a median rupture

A diaphragm is also known as 'hernia diaphragm'. A hernia of the diaphragm is often symptomless and thus without complications. In addition, any complaints may be highly dependent on your posture, the exact location of the fracture port, and the existence of a breakage bag (plus the size and contents of the bulge). However, the main symptoms of a break in the diaphragm are as follows:

• Burning feeling behind the sternum
• Nausea & vomiting
• Acid fires or rises (= reflux)
• Radiating pain (around the stomach / upper abdomen)
• Acid taste in throat and mouth
• Difficulty swallowing (dysphagia)
• Esophagitis (acidic / peptic esophagitis)

The above symptoms of a median rupture occur or worsen often after a heavy meal and / or lying or bending / bending. This, due to leaking / rising / returning gastric acid / gastric juice in the esophagus.

Causes of a medial rupture

The exact underlying cause of a median rupture has not been clear yet. It is well known that your diaphragm can relax / weaken as you grow older. In addition, a diaphragm hernia can be associated with a congenital (growth) aberration. In any case, you are at extra risk of a medial rupture if you:

• To be overweight
• Smokes (cigarettes, cigars, pipes etc.)
• Excessive alcohol is drinking
• Multiple and fierce must sneeze

Abdominal injury (accident, fights, etc.) can also lead to a medial rupture. The same applies to pressure increase due to pregnancy, childbirth or intestinal obstruction (constipation).

Slider & turntable

The opening in the diaphragm (between the abdominal cavity and the thoracic cavity), which causes your esophagus to reach your stomach, is thus termed "hiatus oesophageus." If the hiatus is stretched or torn, one also speaks of a hiatus hernia. This is a median rupture, with a part of the stomach moving out of the abdominal cavity through the relevant fracture, into the thoracic cavity. The stomach is then partially (and usually temporarily) projected above the diaphragm, resulting in gastroesophageal reflux with acid fires.

A distinction is made between 2 types of hiatus hernias, namely the:

• Sliding fracture / sliding hernia: part of the stomach glides through the hiatus to the thoracic cavity and pushes the esophagus upwards
• Scarring / rolling hernia: a para-oesophageal hiatus hernia; In this case (a part of) the stomach penetrates elsewhere from the diaphragm and lies next to the esophagus

It is still sometimes a 3 e type described hiatus hernia; It is a combination of the above 2 diaphragm variants.

Middle rupture at baby, child & adult

A diaphragm hernia occurs in children and adults alike . Here are the 2 (usually different) variants:

A. Centrifughernia in children (usually congenital)

Due to insufficient build-up of the diaphragm, unborn babies can part of the abdominal contents from the abdominal cavity into the thoracic cavity . Usually, the small intestine, colon and / or spleen enter the thoracic cavity. This is an extremely serious, congenital disorder of the diaphragm, with the baby being promptly placed on the respiratory system and being operated as soon as possible. This life-threatening "growth abnormality" is also known as Congenital Hernia Diaphragm (CHD).

Due to an excessive opening in the diaphragm volume at a wrong location in the abdomen / chest, several organs are in a wrong place in the body. As a result, organs can get crushed.

B. Hernia diaphragmatics in adults (mostly wear)

A medieval rupture occurs very often in the Western world. About 40 to 60% of people over 60 years of age run around with a median rupture. However, most do not overlook this because a medial rupture does not always cause complaints. Complications only occur when the stomach slides through the wider opening in the diaphragm. The diagnosis 'hernia diaphragm' is therefore often taken by chance.

A matrimonial rupture in adults is not always recognized as such because its symptoms correspond to a large number of other disorders and conditions.

Treatment of a median rupture

A medial rupture should actually be treated only if it causes complaints such as acid fires, swallowing or other discomfort during or after eating. An inflammation of the esophagus as a result of a median rupture should also be treated.

General guidelines for the treatment of acid fires and esophageal inflammation (gastrointestinal esophageal inflammation) are as follows: Avoid or moderate foods and inhalants which may enhance gastric acid reflux (including reflux)

• Alcohol
• Nicotine ( cigarettes )
• Caffeine & cocoa
• Fat food ( nutritional fat )
• Peppermint

In addition, eat smaller portions and try not to eat shortly before bedtime or long lasting. And further tips and advice for treating a median rupture are as follows:

• Avoid bending, hanging forward and abdominal muscles
• Do not wear tight belts & belts
• Raise the head end and lower the bottom of your bed
• Try to minimize overweight

If necessary, ask your doctor for medicines that inhibit gastric acid production.

Central rupture operation

A large medial rupture sometimes requires an operative correction. Rarely is an emergency operation necessary. Surgical treatment is also important for diarrhea patients who do not respond adequately to medicines. A median rupture surgery is usually performed under general anesthesia. The part of the stomach that is in the thoracic cavity is retracted into the abdominal cavity. The opening in the diaphragm is then reduced. Finally, the upper part of the stomach is dragged around the lower part of the esophagus to increase the lining of the esophagus muscle.

The medial rupture surgery is usually performed through a number of small stomach upsets, a so-called viewing operation, or laparoscopy. The benefits of a laparoscopic mid-rupture surgery include a short hospital stay, less pain, minor scars and a faster recovery. In rare cases, a viewing operation is not possible, but the same procedure is performed via a larger cut in the upper abdomen.

The viewing operation for the treatment of a clinical median rupture is a relatively safe and effective procedure. After surgery, complaints of nausea, vomiting, acid fires, chest pain and food abandonment in about 80 to 90% of patients have disappeared or decreased significantly. Complications that may occur during or after a median rupture surgery include urinary tract infection, surgery or lung infections. But also thrombosis, (after) bleeding, spleen injury, injury to the wandering abdominal nerve or perforation of the esophagus. Most of these complications can be treated conservatively.

Immediately after surgery, solid food may be more difficult due to the applied collar for the esophagus and the swelling of the operating area, so that after the surgical correction of the mid-rupture, liquid feed must be used temporarily.

Note: The mere presence of a mid-rupture is in itself not a reason for surgery.

Finally

It is almost always the case that a stomach ache between the stomach and esophagus-the lower esophagus muscle-is inadequate due to developmental retardation, damage or stretching. Through the rupture in the diaphragm, a part of the stomach can slide upwards; sliding hernia or rolling hernia. As a result gastric acid may enter the esophagus, which may eventually cause irritation or even inflammation of the esophagus. In the majority of cases the severity of the fracture is very small and the condition does not cause any complaints or symptoms. In addition, in the upper abdomen, a stomach rupture may occur in addition to a diaphragm rupture.

Do you have experience with a medieval break? Or do you suffer from a hernia diaphragm or hiatus hernia? Share your findings in a comment below.

Sources:
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