Early Reception Of Mixture And Food As Though

Early reception of mixture and food as though carries out "soft" a gullet. Formation of hems is interfered also by appointment (, , etc.) Which detain development and reduce inflammatory changes in a gullet. Now carrying out early (with 9 - 11th day) a gullet during 1 - 1 1/2 in a combination to hypodermic introduction or during 2 is recognised expedient. Too early, before this term begun gives opposite effect, causing an aggravation of inflammatory process in a gullet and scarring strengthening. Before the beginning it is necessary to make - which will allow to establish burn degree, absence fabrics. a gullet it is unsafe and can become complicated its punching with development purulent and a pleurisy, therefore he should be spent carefully. Hyperbaric oxygenation is applied to preventive maintenance of cicatricial stenoses of a gullet which reduces depth of a zone , delimits , promotes clarification to a surface and causes it by the end of 1st month. suppresses formation of a connecting fabric that leads to development more friable, thin and a gullet hem.

RARE SPECIES OF HERNIAS OF THE STOMACH Hernias

RARE SPECIES OF HERNIAS OF THE STOMACH Hernias a shoot are formed in the presence of defects in it. Through crevices and apertures in a shoot can be stuck out as , and the Diagnosis it is possible to put true hernias on the basis of the found out consolidation in area a shoot, defect presence in a shoot and the data a shoot. Treatment: the surgical Delete a hernial bag and a shoot of the Hernia semilunar lines are localised on a line connecting a navel with top forward of the bone at a place of transition of muscular fibres of internal slanting and cross-section muscles of a stomach in a stretching. Treatment: the surgical. At small hernias hernial gate close - by suture; at the big hernias after sewing together of muscles it is necessary to create . Lumbar hernias. Weak zones of lumbar area are the triangle - of Peti and an interval of Lesgafta - Grjunfelda. The triangle of Peti is formed by lateral - edge of a wide muscle of a back, back edge of an external slanting muscle of a stomach the triangle basis the comb bones is.

In Cases Heavy A Reflux-ezofagita Make Or Transpleural

In cases heavy a reflux-ezofagita make or transpleural with a stomach in a chest cavity. Congenital insufficiency treat conservatively. Usually eventually there comes function normalisation . GULLET DAMAGES Gullet damages divide on internal (closed) from outside a mucous membrane and the external - necks (opened) at - getting wounds and a thorax. Internal damages of a gullet are possible during - carrying out of diagnostic and medical actions: at -, a gullet, . There are gullet wounds from within at hit in it of foreign matters (see "Gullet foreign matters"). gullet walls arise at a long finding in it of probes, from pressure or tubes. Punching of a wall of a gullet can occur at its various diseases: tumours, an ulcer, chemical burns. At an irradiation of malignant tumours of damage of a gullet arise owing to tumour disintegration. Stupid traumas of a neck, thorax and stomach can lead to infringement of a food and walls of a gullet as a result of its squeezing between a breast and bodies of vertebras Thus often mark damage of the next bodies the Straight line to a gullet trauma can occur during operations on bodies and lungs.

Bottom Possesses "unilateral - Passableness". Pressure Suffices For

Bottom possesses "unilateral - passableness". Pressure suffices For advancement of a contained gullet through penalties-diju in 4 mm hg, in a return direction movement is possible only at increase of pressure to 80 mm hg In norm pressure in the field of physiological above, than in a gullet and a bottom of a stomach, and is equal on the average 22 - 28 mm hg It are caused by the tonic reduction of circular muscular - fibres interfering zheludochno-pishchevodnomu a reflux. The - greatest value has a part physiological - which interferes with a reflux at a considerable difference of pressure in a chest and belly cavity. The normal anatomic arrangement of a gullet in relation to a diaphragm is very important for correct functioning of the closing mechanism physiological . Hit gastric - contained in a gullet is interfered also presence of "the mucous socket" in the field of pishchevodno-gastric , by an acute angle of Gisa, presence of the valve of Gubarev - folds of a mucous membrane at a junction of a gullet with a stomach, a switching reflex on at irritation of a mucous membrane department of a stomach food, etc.

At Disintegration And Knots The Macroscopical Picture Differs

At disintegration and knots the macroscopical picture differs from a picture of an ulcer cancer a little. The ulcer type of a cancer of a gullet meets approximately at 30 % of patients. In an initial stage of disease represents a small knot in thickness of a mucous membrane which quickly is exposed . The tumour grows mainly along a gullet, amazing all layers of its wall and extending on surrounding bodies and fabrics. Edges of the formed ulcer dense, the bottom is pruinose is dirty-grayish colour. Tumour early in and the remote lymph nodes. In a wall of a gullet throughout 5 - 6 sm from tumour edge often develop cancer . The infiltrativnaja form of a cancer of a gullet makes about 10 %. The tumour develops in deep layers of a mucous membrane, quickly amazes a layer and extends mainly on a gullet circle. Expanding, the tumour grasps all layers of a wall of a gullet, its gleam. On length the tumour seldom occupies more than 3 - 4 sm, is characterised by plentiful development -, slowly .

At A Congenital Short Gullet And Insufficiency There

At a congenital short gullet and insufficiency there is a reflux-ezofagit, the ulcer, and then a gullet develops , - frequent complication is the pneumonia. The diagnosis congenital anomaly of development of a gullet - establish by means of radiological research at which into a gullet gleam on thin enter 1 - 2 ml . Research allows to find out the blind end - of a gullet, level of its arrangement, extent and narrowing size, gullet expansion, presence - of the message of a gleam of a gullet with bronchial tubes or a trachea. At gullet doubling mark an additional shade with the accurate contours, adjoining a shade and pushing aside a gullet. At a short gullet it has no bends, and the stomach part is located - above a diaphragm. Insufficiency is shown zheludochno-pishchevodnym by a reflux of contrast substance during research. The big role in diagnostics of developmental anomalies - of a gullet play ezofago - and . Treatment: features of surgical treatment a - gullet are defined by its kind.

Apply : Allocate From Surrounding Fabrics To A

Apply : allocate from surrounding fabrics to a neck, make , it and take in an aperture in a gullet wall. At considerable muscular defect or an atrophy - of muscular fibres of a gullet make plastic restoration of its wall by a rag of a diaphragm, a pleura. apply only at the small sizes . after operation makes 1 - 1,5 %. GOOD-QUALITY TUMOURS AND THE GULLET Good-quality tumours of a gullet and are observed seldom. Pathological anatomy: tumours in relation to a gullet wall can be and . On a histologic - structure of a tumour divide on ( - polyps, papillomas) and (, , fibromas, , , , , , etc.). Vnutriprosvetnye tumours settle down more often in or gullet department, - in - its bottom two thirds. From good-quality tumours - of a gullet the most frequent kind is , - developing of smooth muscular fibres. The place second for frequency among good-quality - gullet formations occupy (, , ). represent the thin-walled - formations containing a light viscous liquid. The wall consists of a fibrous fabric with an impurity of smooth muscular fibres and a cartilage.

At A Thrombosis Of Venous Knot The Big

At a thrombosis of venous knot the big hypodermic vein tie up and cross at a place of its confluence of a deep vein of a hip to warn and thrombosis distribution on a deep vein of a hip. A trombirovannuju vein . Sudden infringement of earlier not coming to light hernias. On a belly - wall in typical for formation of hernias sites can remain after a birth (predsushche-stvujushchie hernial bags). More often such preprepared hernial bag in areas is brjushinno-pahovyj a shoot the Reason of sudden occurrence of a hernia and its infringement sharp increase of intrabelly pressure (- considerable physical pressure, strong cough, ) is-. In the anamnesis patients do not have instructions on signs before - existing hernias: , painful sensations in the places typical for localisation of hernias. The basic sign of suddenly arisen restrained hernias - acute pain occurrence in typical places hernias. At sudden occurrence of an acute pain in areas, in the field of the femoral channel, in a navel it is necessary - to define at inspection - of the patient at the most painful sites corresponding to hernial collars.

Small Hernias With The Narrow And Rubtsovo-changed Neck

Small hernias with the narrow and rubtsovo-changed neck of a hernial bag are restrained more often, than the big hernias. The infringement is not destiny only a hernia long existing. The hernia at occurrence can prove infringement at once. Frequency of separate kinds of hernias at adult patients with the restrained hernias: hernias - 43,5 %, postoperative hernias - 19,2 %, umbilical hernias - 16,9 %, femoral hernias - 16 %, hernias of a white line of a stomach - 4,4 %. Any body can be restrained, the small intestine and the big epiploon are more often restrained. On the occurrence mechanism distinguish , and mixed, or combined, infringement. The Elastichesky infringement occurs at the moment of sudden - increase of intrabelly pressure at physical activity, cough, , etc. Thus there comes a restretching of hernial gate therefore in a hernial bag leaves more than usually an internal. Returning of hernial gate in a former condition leads to infringement of contents of a hernia. At infringement the left.

Among Other Symptoms Gullet Narrowings Are Often Observed

Among other symptoms gullet narrowings are often observed pains of a breast at the food intake, raised , an eructation, a heartburn. As a result of food infringement the exhaustion of patients progresses. To one of the most frequent complications of cicatricial narrowing of a gullet is a gullet food at which ( urgent medical aid is necessary for extraction of a food lump). - Owing to food and it chronic inflammatory diseases of bronchial tubes and lungs often develop - in respiratory ways. - As a result of longitudinal cicatricial shortening of a gullet probably formation or hernia increase diaphragm apertures. Development of a cancer tumour in area is possible. At patients with stenoses more often, than at healthy people, punching of a gullet is observed during tool researches. The diagnosis of a stenosis of a gullet is confirmed with the data of the anamnesis and radiological research with liquid and dense contrast - substance. Gullet narrowings have the form, the relief of a mucous membrane in the field of narrowing is absent, is not defined.

Borders Of A Femoral Ring: From Above -

Borders of a femoral ring: from above - a sheaf; from below - a comb bones; outside - a femoral vein; to the middle - a sheaf. In normal conditions of the femoral channel does not exist. It is formed at formation of a femoral hernia. The oval pole on wide hips is an external aperture of the femoral channel. The most frequent form of a hernia is the hernia leaving a belly cavity through a femoral ring. The hernial bag advances ahead of itself and a lymph node of Pirogova - Rozenmjullera. Leaving from under sheaves, the hernia settles down in an oval pole from a femoral vein. The hernial bag is covered here fatty , superficial and a skin. Less often the femoral hernia leaves between a femoral artery and a vein. Hernias of a vascular lacuna can be identified only during operation. Sometimes the - hernia leaves through defect sheaves. Occasionally observe hernias of a muscular lacuna, usually in a zone of passage of a femoral nerve. This hernia owing to its characteristic arrangement a vascular bunch can be distinguished before operation.

At Germination By A Tumour Of Returnable Nerves

At germination by a tumour of returnable nerves at patients hoarseness of a voice, defeat of knots - of a sympathetic nerve develops-, the syndrome of Gornera is shown. a wandering - nerve can cause a bradycardia, fits of coughing, vomiting-. Germination by a tumour a nerve is accompanied - by a diaphragm paralysis on the corresponding party, and a humeral - texture - a pain, , and then a paralysis of the top finiteness. Transition of a tumour to a throat is accompanied by change - of sounding of a voice, occurrence of a short wind and breath. At (germination) of a trachea and bronchial tubes there is a cough, a short wind (at 7,2 %). Formation pishchevodno-trahealnogo or a pishchevodno-bronchial fistula is shown by cough at - liquid reception-. This complication usually comes to an end with development of a pneumonia, an abscess or a lung gangrene. Owing to transition of an infection from a gullet can develop , , -. At destruction by a tumour of a wall of a large vessel there are massive bleedings.

For A Cancer Progressing Increase Of Impassability Of

For a cancer progressing increase of impassability of a gullet which at one patients develops quickly, at others - slowly (during 1 1/2 - 2 years) is characteristic. Infringement of passableness of a gullet is connected not only with narrowing of its gleam by a tumour, but can be caused development pe-rifokalnogo inflammations, occurrence of a spasm of a gullet at defeat by a tumour nervous textures. More often the spastic phenomena mark at tumours. In a - disease initial stage arises at proglaty-vanii the dense or not enough chewed food. Patients feel as though its "sticking" to a wall of a gullet or a time - delay at certain level. The water drink usually eliminates - these phenomena. Even well chewed food further ceases to pass, and patients are compelled to accept semi-fluid - and liquid food, becomes a constant and arises even at the liquid use. Sometimes after the proof period there is an improvement of passableness of food on a gullet, connected with tumour disintegration. To occurrence can precede appearing at firm food of sensation of a foreign matter in a - gullet, feeling "" behind a breast, morbidity at defeat level.

Edges Of Hernial Gate Firm Owing To Development

Edges of hernial gate firm owing to development of a dense cicatricial fabric. External covers of a postoperative hernia are presented by a cicatricial fabric, is intimate with a hernial bag, or a skin with hypodermic and a postoperative hem in the middle. - Muscles adjoining - to hernial collars can also - be changed-. The hernial bag quite often happens multichamber, and a hernia . Recognition of postoperative hernias does not represent - difficulties. Detection in a postoperative hem hernial , appearing at , cough, is sufficient for diagnosis statement. For definition of the body which is in a hernial bag, make radiological research of a gastroenteric path. Treatment: the surgical. At the big hernias operation presents difficulties because of unions of contents of a hernia with a - hernial bag and presence of major defects of a belly wall. At small hernias probably closing of defect at the expense of soft fabrics. During operations concerning the big postoperative - hernias apply methods , and methods of the combined plasticity of defects of a belly wall.

It Is Necessary To Exclude Also A Gullet

It is necessary to exclude also a gullet pushing off from the outside tumours - back , an intrachest craw, the aortas, the increased lymph nodes, filled . The important radiological sign a gullet - is its displacement Even substantial growth of the next bodies - long time does not cause as smeshchae-most a gullet in friable connecting it is great enough. and infringement of passableness of a gullet can be caused (cicatricial change - ), arising after inflammatory - diseases of lungs and lymph nodes . In the anamnesis these patients have instructions on sharp and chronic diseases - of lungs, causeless rises in temperature of a body. at them develops quickly. At radiological research - contours of the narrowed site of a gullet equal, are more rare - wavy-, the mucous membrane relief is kept, the gullet wall at swallowing and breath is not displaced, round a gullet the shade condensed is visible. At a gullet tuberculosis a clinical and radiological picture of disease can have a strong likeness with displays of a cancer of a gullet.