Kalp Boşluklarina Basi Yapan Sindirim sistemi Organlari
2014
Kalp bosluklarinin komsu yapilar veya sindirim organlari tarafindan basiya ugramasi kalp hastaligina benzer semp- tomlara neden olabilmektedir. Burada sindirim organ- larinin herniasyonunun kalp bosluklari uzerinde semp- tomatik basisina neden olan iki olgu sunulmustur. Yorgun- luk ve nefes darligi ile basvuran ilk vaka da ekokardiyografi de sol atriumun posterior tarafindan basi yapan ekolusent kitle tespit edilmis, kesin tani icin cekilen bilgisayarli to- mografi de bunun bir hiatal herni oldugu saptanmistir. Bir kac aydir eforla artan yorgunluk ve alt ekstremitelerde odem ile basvuran 62 yasindaki ikinci vakada, sag kalp bosluklari uzerine baski yapan buyuk bir diyafragmatik gastrik herni tespit edildi. Burada sunulan hastalarda diyafragmatik ve hiatal herni tanilari oncelikle ekokardiyo- grafi ile daha sonrada tomografi ile konulmustur. Ekokar- diyografide herni keselerinin kalp bosluklari uzerindeki basi yapici etkisi acikca tespit edilmistir. Heart chamber compression by neighboring structures or digestive organs can give clinically symptoms mimicking intrinsic heart diseases. We describe here two persons who developed gastric hernia leading to symptomatic compres- sion on heart chambers. The first case presented with chief complaint of fatigue and shortness of breath. Echocardio- gram revealed an echolucent mass showing compression on the posterior aspect of the left atrium. Computed tomo- graphic imaging ultimately identified that the mass was a hiatal hernia sac. The second case was a case of a large diaphragmatic hernia associated with right atrium and right ventricular compression in a 62 year old man who present- ed with increasing effort fatigue and pitting edema in lower extremities during the previous months. The present diag- nosis of hiatal and diaphragmatic hernia was made firstly on the basis of echocardiogram and subsequent computed tomography. Echocardiography showed clearly the com- pressive effect of the hernia sacs on the heart chambers.
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