Often Simultaneously There Are Damages Of A Thorax,

Often simultaneously there are damages of a thorax, bones of a basin, bodies of a belly - cavity. At ruptures and wounds of a diaphragm owing to - negative intrachest pressure there comes moving to a - pleural cavity of a stomach, a thin or thick gut, an epiploon, a spleen, a liver part. Moving of bodies can arise as directly after a trauma, and after any - time interval. Open damages of a diaphragm happen at koloto-rezanyh and fire wounds. They - are in most cases combined with damage of bodies of a chest and belly cavity. The clinic and diagnostics, in the sharp period prevail - symptoms of an accompanying trauma ( a shock, cardiovascular and respiratory insufficiency, a bleeding, a peritonitis, , crises of bones). Have diagnostic - value symptoms a lung and displacement of bodies . There can be an infringement - of the bodies which have dropped out in a pleural - cavity. To suspect diaphragm wound it is possible at presence over a - thorax at , intestinal noise at , at development of symptoms of intestinal impassability, - occurrence haemo- or at stomach wounds.

- Surgical Intervention Make Through 2 - 3

- Surgical intervention make through 2 - 3 after the - termination of beam therapy. At tumours, in the presence of contra-indications to radical operation make palliative interventions for the purpose of restoration of passableness of a gullet, improvement of a food of the patient. To palliative operations carry: palliative resections-, tumours an artificial limb (endoproteziro-vanie), imposing . Beam treatment apply both at radical, and at palliative therapy of a cancer of a gullet. Optimum results are received at use of sources high - (gamma therapies, brake radiation and fast ), providing leading to a tumour of a gullet of a high dose - of radiation. At a cancer of the top third of gullet after - imposing the patient spend radical beam therapy in a total dose 60 - 70 Gr (6000 - 7000 it is glad) at a - daily dose 1,5 - 2 Gr (150 - 200 is glad). At a cancer of an average third of gullet the patient impose , and then spend palliative beam therapy in a dose 20 - 40 Gr (2000 - 4000 it is glad), - which overall objective - removal , pains and delay of progressing of tumoral process.

Outside The Gullet Is Surrounded Friable Connect-telnoj In

Outside the gullet is surrounded friable connect-telnoj in which pass lymphatic, blood vessels and nerves the cover has only gullet department. Gullet blood supply in cervical department is carried out from the bottom thyroid arteries, in chest department - for the account actually the arteries departing from an aorta, branches of bronchial and intercostal arteries. Blood supply gullet department occurs from an ascending branch of the left gastric artery and a branch bottom arteries. In chest department gullet blood supply has segmentary character, therefore its allocation on a considerable extent from surrounding fabrics during surgical interventions can lead walls. Outflow of a blue blood from gullet department goes from and venous textures in and further in a vein. From the top departments of a gullet the blue blood flows through the bottom thyroid, unpaired and semiunpaired veins in system of the top hollow vein. Thus, in the field of a gullet are available between system and top hollow veins.

At A Method Apply To Closing Of Defect

At a method apply to closing of defect of a belly wall wide hips, plates and laces from skin. At a method use grids from synthetic fabrics (lavsan, teflon, , etc.). Implanted between layers of the rubtsovo-changed fabrics the implant can be used as a skeleton which then is filled with a cicatricial fabric in the course of healing-. This method apply at repeated relapses of postoperative - hernias when there is an extensive trellised defect in a hem, and fabrics of a belly wall are not differentiated almost-. To close defect local fabrics it is not obviously possible-. Preventive maintenance: a choice of correct operational - access without considerable damages of muscular layers, and nerves; refusal of application resolving a - material; restriction of indications to and a belly cavity; level-by-level mending of a wound of a belly - wall; preventive application of antibiotics during the operation accompanied by opening of hollow bodies and possible -, an exception of excessive physical activity after operation.