The Violent Reposition Of The Restrained Hernia Made

The violent reposition of the restrained hernia made by the patient, is observed seldom. In medical institutions violent reposition of a hernia is forbidden At violent reposition of the restrained hernia there can be damages of a hernial bag and contents of a hernia up to rupture of a gut and it to development of a peritonitis and an intrabelly bleeding-. The peritonitis, an intrabelly bleeding are indications to emergency operation the operation Purpose - audit of bodies of a belly cavity, a bleeding stop, removal of a source of a peritonitis, a belly cavity (sm "Peritonitis"). At violent reposition the hernial bag can be displaced in space together with the contents restrained in area of a neck of a hernial bag. At a separation in the field of a neck of a hernial bag there can be an immersing of the restrained loop of a gut together with a restraining ring in a belly cavity or in space. Important in due time to distinguish imaginary board of a hernia as at the patient the phenomena of intestinal - impassability and a peritonitis can quickly develop-.

Most Often Happen In Chest Department Of A

Most often happen in chest department of a gullet. Pathological anatomy: glotochno-pishchevodnye develop slowly, drinks are formed in a back wall, is direct over an input in a gullet, more often in the field of a triangle of Lane - Gakkermana where the muscular cover drinks is presented by weak muscular bunches - drinks, is more rare - in the field of a triangle of Lajmepa limited from above m.cricopharyngeus, and from sides - - longitudinal muscular fibres than a wall. The major importance in formation has perstnevidno-pharyngeal muscles (infringement of disclosing - top in reply to swallowing). go down downwards between a back wall of a gullet and a backbone, can be displaced under lateral muscles of a neck. Their size is various, they have a wide mouth. The wall does not contain muscular - fibres, usually not with surrounding fabrics, - its internal surface is covered by a mucous membrane drinks, on it there can be superficial erosion or hems. settle down on a forward or left lateral wall of a gullet is more often, their diameter seldom exceeds 1 - 2 the Bottom see is usually directed upwards and with the - next bodies, the wall has a structure of a wall of a gullet.

At Detection A Blind Gut Make Median And

At detection a blind gut make median and carry out a resection of the right half of thick gut with imposing . Operation finish plastic arts of hernial gate. At bladder walls the resection of a bladder with - imposing is necessary-. In hard cases - also impose . The sixth stage - the restrained epiploon separate sites without formation of the big general . With massive an epiploon probably and occurrence - as a result of this bleeding from vessels of an epiploon of century a belly cavity. The seventh stage - at a choice of a method of a plasticity of hernial gate it is necessary to prefer the most simple. For example, at small slanting hernias at young men it is necessary to apply a way Zhirara - Spasokukotsky - Kimbarovsky, at straight lines and difficult hernias - ways Bassini and Postempsky. At the restrained hernia complicated by a phlegmon of a hernial bag, operation should be begun with median (the first stage) for danger reduction a belly cavity contents of a hernial bag. During time make a resection of a gut within viable fabrics.

Occasionally Develops - A Cancer. From Other Malignant

Occasionally develops - a cancer. From other malignant tumours - of a gullet it is necessary to note , consisting of ferruterous both elements, and (a cancer and sarcoma combination). The international classification of a cancer of a gullet provides the - tumour characteristic on system TNM. - a primary tumour TIs - . THAT - is not present display of a primary tumour. 1 - The tumour involves less than 5 sm of length of a gullet, without causing gleam narrowing. There is no circular defeat of walls of a gullet. Vnepishchevodnogo - distribution of a tumour is not present. 2 - A tumour more than 5 sm on length of a gullet. The tumour of any size - causing narrowing of a gullet. A tumour extending on all walls - of a gullet. Vnepishchevodnogo distribution of a tumour is not present. - the tumour extends on the next structures. N - lymph nodes NO - lymph nodes are not palpated. N1 - Mobile lymph nodes on the defeat party. N1a - The increased lymph nodes do not contain metastasises. N1b - The increased lymph nodes contain metastasises.

A Cancer Of This Localisation Treat By Means

A cancer of this localisation treat by means of beam therapy more successfully. At a cancer gullet department make operation - of Dobromyslova-Tereka. From access - delete chest department of a gullet and impose . Subsequently (later 3 - 6 ) create an artificial gullet from thick or a small intestine. At strong young men probably performance of a resection of a gullet with imposing between the rest of a gullet and the stomach moved to the right pleural cavity (Lewis's operation). At a cancer department of a gullet choice operation is the resection of a gullet with one-stage imposing intrachest pishchevodno-gastric under an arch of an aorta or at its level. Good results from the combined beam and surgical treatment are received. Preoperative beam therapy spend on a beta throne or in a dose 30 - 50 Gr (3000 - 5000 it is glad). Influencing the basic centre of defeat and the possible centres , beam therapy allows to translate a tumour from doubtful in , to eliminate accompanying inflammatory changes.