Low Arrangement Of A Diaphragm Mark At An

Low arrangement of a diaphragm mark at an emphysema easy, big hernias of a forward belly wall, , constitutions. Paradoxical movement of a diaphragm (lifting at a breath and lowering at an exhalation) happens at paralyses and its relaxation. For studying of character of movements of a diaphragm and its - functional condition use special radiological methods of research: , a tomography. Position and a diaphragm condition judge at contrast radiological research of a gullet, a stomach, intestines, at imposing artificial , and . Change of position and diaphragm function is accompanied by reduction of respiratory volume of lungs, changes . DIAPHRAGM DAMAGES The closed damages of a diaphragm arise at road - traumas, falling from height, an air contusion, a stomach. Diaphragm rupture in these cases is caused by sudden increase of intrabelly pressure. Damages - settle down in area the centre or in a place of its transition in a muscular part of a diaphragm is more often-. In 90 - 95 % of cases occur rupture of the left dome of a diaphragm.

In A Hernial Bag Of Bodies Occurs Outside.

In a hernial bag of bodies occurs outside. The kalovoe infringement arises at easing intestines, is more often observed at people of advanced age. Following-tvie congestions of a considerable quantity intestinal contained in a gut which is in a hernial bag, occurs a - departing loop of this gut, then pressure of hernial gate upon contents of a hernia amplifies and to joins , thus there is a mixed form of infringement. Pathological anatomy: a development principal cause changes in the restrained body is infringement krovo - and . At infringement of a gut owing to venous occurs in a gut wall, in its gleam and in a cavity of a hernial bag. A liquid in a hernial bag name "hernial water". At fast simultaneous a restraining ring of veins and arteries a gut which are in a hernial bag, "hernial water" is not formed, develops "a dry gangrene" restrained gut. In the beginning of infringement the gut gets colouring, "hernial water" the transparent. Nekrotichesky changes in a gut wall begin with a mucous membrane.

Stomach Survey. In Vertical Position Of The Patient

Stomach survey. In vertical position of the patient a normal - configuration of a stomach characterises moderated areas and some the bottom half of stomach. On a back at not corpulent patient level of a forward wall of a stomach is in a prone position below breast level. Uniform - a stomach observe at adiposity, intestines-, a liquid congestion in a belly cavity . Non-uniform - a belly wall can be at - stomach hernias-, at impassability of intestines, at , abscesses - of a belly wall and localised in a belly cavity, at the tumours which are starting with a belly wall and bodies of a belly - cavity. Change of a configuration of a belly wall observe at excessive strengthening a stomach and an intestines. Gathered in the - stomach happens at the exhausted patients, at sharp pressure of muscles of a belly wall (a symptom of muscular protection - a reflex at irritation ). In the presence of - postoperative hems their localisation, the sizes, defects in a belly wall in the field of hems (- postoperative hernias) should be noted-.

Congenital (insufficiency) - A Consequence - The Nervously-muscular

Congenital (insufficiency) - a consequence - the nervously-muscular device physiological or straightening of a corner of Gisa. The clinical picture is similar to displays of a congenital short gullet. Congenital short gullet. At this developmental anomaly the stomach part appears located above a diaphragm. The - clinical picture is caused by insufficiency , - accompanied zheludochno-pishchevodnym a reflux. After feeding at children arise , vomiting sometimes with an impurity of blood as a result of development . Complications of developmental anomalies of a gullet. The most frequent - complication at congenital , stenoses, pishchevodno-respiratory fistulas is the pneumonia. a gullet can lead to starvation of the child, at stenoses develops - stagnant . bronchial tubes the increasing doubled gullet causes a repeated pneumonia, development , the suppuration and break in respiratory ways or a pleural cavity is possible. from a stomach mucous membrane can be exposed with bleeding and punching development.

The Interval Of Lesgafta - Grjunfelda Is Between

The interval of Lesgafta - Grjunfelda is between an internal slanting muscle of a stomach - in front and from below, longitudinal muscles of a backbone and a square muscle from the - middle, the bottom gear muscle and XII edge from above. The interval looks like a - quadrangle. A bottom of this interval is a cross-section muscle - of a stomach. Through these intervals there can be lumbar hernias. On an aetiology they happen congenital, got (traumatic and spontaneous). Diagnostics of these hernias is not difficult. Treatment: the surgical. Zapiratelnye hernias leave through defects membranes apertures. Meet at women in advanced age is more often. It it is possible to explain in the big size apertures and more expressed - inclination of a basin at women. Hernial settles down on a lobby -. However happen hernias when visible approximately is not present. Such hernias are distinguished only at infringement - during operation. Treatment: the surgical. Promezhnostnye hernias (forward and back).

Lymphatic Vessels Cross, Their Central Ends , And

Lymphatic vessels cross, their central ends , and peripheral with veins on type the end sideways or the end in the end. Thus carry out to 6 - 10 . The operations executed in initial stages chronic , completely normalise from the amazed - finiteness, in later stages allow to achieve considerable reduction of a hypostasis of a skin and hypodermic -. GULLET The gullet represents a muscular tube in length about 25 sm, inside a mucous membrane and surrounded with a connecting fabric. It connects to a drink with a stomach part. The gullet begins at level of VI cervical vertebra and is stretched to level of XI chest vertebra. The input in a gullet is located at level a cartilage and will defend from a first line of the top cutters on 14 - 16 sm ("a gullet mouth"). In this place there is a first physiological narrowing. a gullet divide into three departments: cervical (5-6 sm), chest (16 - 18 sm) and - (1-4 sm). The second physiological narrowing of a gullet is approximately in 25 sm from edge of the top cutters at level tracheas and crossings of a gullet with the left main bronchial tube, the third corresponds - to level apertures of a diaphragm and is located on distance 37-40 see In a cervical part and in the beginning of chest department to an arch of an aorta the gullet is located to the left from an average line.

At Complications Illness (an Ulcer, A Bleeding), To

At complications illness (an ulcer, a bleeding), to the expressed hernia a diaphragm aperture, and also unsuccessfulness of long conservative therapy accepts - surgical treatment. Carry out on Nissenu. Operation consists in department of a gullet a wall of a bottom of a stomach. A stomach fix to a diaphragm around apertures several seams. Good results are noted more than at 90 % operated. PEPTICHESKY ULCERS OF THE GULLET Peptichesky ulcers of a gullet make about 1,5 % of diseases - drinks and a gullet. To thicket men, - mainly average and advanced age fall ill-. Aetiology and : in development of an ulcer of a gullet action the factor matters. Disease is often combined with a stomach ulcer of a stomach and a duodenal gut, with a hernia diaphragm apertures, a congenital short gullet, observed after the operations breaking function physiological , after imposing ezofagogastro-anastomoza, i.e. In those cases when there is a zheludochno-gullet th a reflux. Presence at sick infringements of nervous regulation a wall and changes in the central departments of nervous system (in a cerebral cortex, gipotalamiche-skoj areas, a grey hillock) is doubtless.

The Way Spasokukotsky Is Updating Of A Way

The way Spasokukotsky is updating of a way Zhirara - and differs from it only that to to a sheaf - muscles internal slanting simultaneously file and cross-section together with the top rag an external slanting muscle of a stomach At this way the sheaf is less injured . Seam of Kimbarovojugo. Provides connection of the fabrics with the same name. By means of this seam the edge of the top rag an external slanting muscle shrouds edges of internal slanting and - cross-section muscles. The first introduction of a needle is spent on distance by of 1 sm from edge of the top rag an external slanting muscle, then, having spent a needle through edges of muscles, stitch again at the edge the Same thread stitch a sheaf In comparison of the fabrics with the same name is provided. The way Bassini - provides strengthening of a back wall - the channel. After high removal of a hernial bag seed remove aside and under it file internal slanting and cross-section muscles together with cross-section a stomach to to a sheaf.

A Hernial Bag, Edges Sew It In A

a hernial bag, edges sew it in a cross-section direction. Hernial gate expand in a cross-section direction - with two cuts through a white line of a stomach and a forward wall of a vagina of direct muscles to their internal edges. P-shaped seams file the bottom rag under top which in a kind separate seams file to the bottom rag. HERNIAS OF THE WHITE LINE OF THE STOMACH The white line of a stomach is formed skintight to each other by bunches of fibrous fibres wide belly muscles. Between them there are cracks and deepenings which can serve as contributing anatomic factors in - formation of hernias of a white line of a stomach. In the beginning through such crack passes , forming -, and then the hernial bag is formed. Hernias of a white line of a stomach seldom happen big, process can sometimes stop - at a stage . On localisation of a hernia of a white line of a stomach can be/over-umbilical, and . Podpupochnye hernias - meet extremely seldom. Okolopupochnye hernias settle down - more often sideways from a navel.

Observe Cases Of Spontaneous Rupture Of A Gullet.

Observe cases of spontaneous rupture of a gullet. Factors contributing to spontaneous ruptures of a gullet, are alcoholic intoxication, an overeating, vomiting during emetic movements occurs simultaneous disclosing , pressure of muscles of an abdominal tension, reduction of a diaphragm and a muscular cover of a stomach, glotochno-pishchevodnyj remains closed. As a result of pressure substantial increase in a gullet there is longitudinal or cross-section a rupture of its wall, more often directly over a diaphragm ( in 95 %, right in 5 % of cases) gullet Rupture arises at attempt to constrain vomiting or at coordination infringement in work specified above as a result of strong alcoholic intoxication, diseases of the central nervous system. Rupture looks like a linear wound is more often, can extend on a stomach. Develops sharp , at damage pleurae - it . At spontaneous ruptures of a gullet the pain arises suddenly (more often during vomiting) in area a shoot, can in area, a back, the left shoulder.

The Diagnosis Represents Great Difficulties. On Clinical Displays

The diagnosis represents great difficulties. On clinical displays the infringement of a gut differs oi infringements of a gut from it . There are no shock phenomena. Symptoms of intestinal impassability can be absent as contents occurs freely in the diarrhoeia is sometimes observed. There is a constant pain in a place of infringement of an intestinal wall in a hernia where it is possible to probe small painful dense formation. The pain is unsharply expressed as according to the restrained site of a gut is free. It is especially difficult to distinguish infringement when it happens the first clinical display of the arisen hernia. At corpulent women it is especially difficult to probe a small swelling under a sheaf. The general condition of the patient can remain in the beginning accrediting then progressively worsens in connection with development of a peritonitis of a phlegmon of fabrics surrounding a hernial bag At patients with the started form in a femoral hernia inflammation development in fabrics surrounding to a hernial bag can feign infringements sharp or .

Seed Stack On The Generated Back Wall The

Seed stack on the generated back wall the channel. Operation finish creation an external slanting muscle of a stomach and formation - of an external aperture the channel. Way the Poppy-blowing - Venglovsky. Kukudzhanova is close enough by the way. Its essence consists in narrowing of an internal aperture the channel and reconstruction of a back wall the channel. Deep a ring form by a cross-beam - On a vagina of a direct muscle of a stomach do big a cut in length 4 - 5 sm to improve mobility - of sewed fabrics. Cross-section together with the connected - sinew of internal slanting and cross-section muscles frequent seams sew to to a sheaf (from howl sheaves to femoral vessels) Stack seed and in a kind sew an external slanting muscle, forming an external aperture the channel. The way Postempsky consists in a complete liquidation - the channel, an interval and in creation the channel with absolutely new direction. Seed as it is possible further in a direction, at the medial - party narrow internal a ring.

The Bleeding, More Often Sudden, Arises Almost At

The bleeding, more often sudden, arises almost at 50 % of patients-. At allocation of scarlet blood from a mouth it is difficult to spend the - differential diagnosis with a pulmonary bleeding. At blood hit in a stomach emetic weights can get colour of a coffee - thick, in this case difficultly distinguish a bleeding - from the gastric. The profuznoe bleeding can lead to a heavy anaemia and end with death of the patient Against a - chronic ulcer of a gullet the cancer can to develop. The clinical picture of disease allows to suspect - presence gullet ulcers. The basic radiological symptom of an ulcer of a gullet is presence of a niche with inflammatory - shaft around. It is possible to observe also strengthening - gullet walls, local expansion of its gleam over an ulcer, convergence of folds of a mucous membrane to the niche basis to Confirm the diagnosis ulcers of a gullet and to spend the differential diagnosis with and a malignant - tumour helps with . , research and pharmacological test help to spend the differential diagnosis with At an ulcer of the big sizes it is necessary to exclude a - gullet for which the - constancy of its form revealed at radiological - research and sizes is characteristic-, absence - of a site of spastic reduction of a gullet should be remembered possibility of development of nervously-trophic ulcers at tumours, a trauma and inflammatory diseases of the central nervous - system, , and also the ulcers formed at a tuberculosis, a syphilis and fungoid defeats of a gullet.

EXTERNAL HERNIAS OF THE STOMACH External Hernia Of

EXTERNAL HERNIAS OF THE STOMACH External hernia of a stomach - frequent disease, make 3 - 4 % of all population the Hernia limits - work capacity , poses hazard to life the - patient because of possible development of complications (infringement, an inflammation-). Elements of an external hernia of a stomach: hernial gate-, a hernial bag, contents of a hernia, a hernia cover. Hernial gate represent weak places in myshechno-aponevroticheskoj to a stomach wall, through which internal - with leave a belly cavity. - Such weak in places there can be natural channels or the cracks which are passing in thickness of a belly wall the channel, the femoral channel, the umbilical channel, cracks between the fibres - forming a white line of a stomach, a semilunar line, an aperture, sciatic apertures Hernial gate - can be defect in myshechno-aponevroticheskom a layer or the channel which includes a deep aperture, directly channel and an external or superficial aperture. The gryzhevyj bag represents - through hernial gate In a hernial bag distinguish a - mouth, a neck, a body and a bottom.

At The Big Hernias Of A White Line

At the big hernias of a white line of a stomach use a method of Sapezhko. At a divergence of direct muscles of a stomach accompanying a hernia apply a method of Napalkova. After allocation of hernial gate and removal of a hernial bag dissect vaginas of direct muscles of a stomach lengthways on internal edge and sew at first internal, and then external edges vaginas. Thus create doubling of a white line of a stomach. TRAUMATIC AND POSTOPERATIVE HERNIAS Traumatic hernias result from the trauma of a stomach accompanied by hypodermic rupture of subject muscles, - and . Under influence pressure together with an internal - it is stuck out in a place of rupture and the hernia is formed. At the moment of reception of a trauma patients mark a severe pain which gradually passes within several days. If the patient arrives directly after a trauma it is possible - to find out the bruises formed on a place of rupture - of fabrics of a belly wall. Quite often the pain is accompanied by irritation symptoms .