Research Through A Vagina It Is Necessary To

Research through a vagina it is necessary to spend It at all sharp diseases of bodies of a belly cavity - it is necessary for diagnostics of the gynecologic diseases - which are at the bottom of a sharp stomach, and also for revealing - of distribution of inflammatory process on a small basin. At research through a vagina it is possible to reveal the vagina arches, morbidity and increase in appendages of a uterus and painful formation in to a pipe at trumpet pregnancy. the vagina arches happens at a congestion in a cavity of a small basin of blood or . Laboratory analyses: haemogram, urine, a liver and a pancreas. Radiological research: a thorax-, survey a stomach (from a diaphragm to ) for revealing of mobility of a diaphragm, a congestion of free gas under a diaphragm or in intestines, liquid levels in intestines (at impassability); blackouts ; survey - and urography for revealing of stones in kidneys and -; research with a summer residence through a mouth - of water-soluble contrast at suspicion on punching of a stomach or a duodenal gut; at suspicion on impassability.

THE GULLET A Gullet - Limited Walls. Distinguish

THE GULLET a gullet - limited walls. Distinguish and . are formed owing to - walls under the influence of high the - pressure arising during its reduction. Development - fractional is connected with inflammatory process in - surrounding fabrics and formation of hems, which extend a wall of a gullet towards the amazed body ( , chronic , a pleurisy) the - mechanism is observed by Traktsionnyj - at the very beginning of development , then join factors owing to what becomes pulsionno-traktsionnym. subdivide depending on an arrangement on glotochno-pishchevodnye , (, ), Distinguish true - which wall contains all layers of a wall of a gullet, and in which wall there is no muscular layer. The overwhelming - majority got, congenital - meet extremely seldom. At infringements of a motility - of a gullet observe , arising - only at the moment of reduction , at a relaxation of a gullet they disappear. are observed seldom aged till 30 years and it is frequent after 50 years; among patients men prevail.

The Course Often Happens Twisting, Excentricly Located. At

The course often happens twisting, excentricly located. At sharp narrowings arises gullet expansion. Clinic and diagnostics: the basic symptom after-burn - which appears with 3 - 4th weeks from the disease beginning. In the beginning it is unsharply expressed-, arises incidentally, it is accompanied by unpleasant sensations behind a breast. Eventually gullet narrowing progresses, as the surface of the narrowed site - is exposed food that is accompanied by vospalitelno-cicatricial process. Expressiveness increases, full impassability of a gullet can develop. The food delay causes a pain and . At high stenoses of a gullet the food during swallowing can get to respiratory ways, causing , attacks - of painful cough and an asthma. At it is long existing narrowings department of the gullet, accompanied it expansion-, gullet contents are exposed chemical and, - to bacterial decomposition that causes the inflammatory process leading still of a gullet, to development . in these cases arises through a considerable time interval after meal.

The Diagnosis: In Typical Cases Comes Easy. The

The diagnosis: in typical cases comes easy. The basic signs: sharply arisen pain and earlier hernias. Usually the infringement occurs in an external - aperture the channel. At research of the patient find out in areas painful, strained, hernial . If the intestinal loop is restrained, symptoms intestinal impassability join. The infringement in an internal aperture the channel is possible ( the infringement) That is why in the absence of hernial is necessary to conduct manual research the channel instead of to be limited to research only external rings Entered in the channel a finger it is possible to probe small painful consolidation at level of an internal aperture channel Retrogradnoe infringement. the small intestine probably infringement of a thick gut of the big epiploon, etc. Retrogradnoe infringement is restrained arises more often when in a hernial bag intestinal loops (two or more) are located some, and intermediate their binding loops are in a belly cavity to Infringement binding intestinal loops of Nekroz are exposed in a greater degree begins earlier in these intestinal loops located above a restraining ring.

Treatment Gives Fast Clinical Effect At The Expense

Treatment gives fast clinical effect at the expense of removal an inflammation and reduction of the sizes of a tumour. At a gullet beam therapy is inefficient. Beam therapy is counter-indicative at a serious illness of cardiovascular and respiratory systems, - bodies, the central nervous system, tumour disintegration, a bleeding-. At impossibility of performance of surgical or beam treatment at a gullet cancer the - chemotherapy (a combination a number - 5-ftoruratsil or with and ) can be applied as - palliative means. Chemotherapy of a cancer of a gullet till now in connection with low sensitivity of a tumour to known antineoplastic preparations. At all patients with the inoperable form of a cancer of a gullet - it is shown carrying out of the symptomatic therapy directed on removal of pains, liquidation of infringements of a food. The five years' - survival rate after radical operations makes less than 10 %. GULLET SARCOMA The sarcoma - malignant a tumour, - makes 1 - 1,5 % of all malignant tumours of a gullet, meet at men (at 75 %) is more often.

Has A Soft Consistence-, Decreases At Pressing, After

has a soft consistence-, decreases at pressing, after water reception at - over it it is possible to define splash noise. It is possible spontaneous - not digested food from a gleam at certain position of the patient, difficulty of breath because of trachea squeezing, occurrence voices at a returnable nerve At food intake at patients can develop "a blockade phenomenon", shown by a face reddening, sensation - of shortage of air, dizziness, the - putrefactive smell from a mouth appears the unconscious condition disappearing after vomiting At a long delay of food in -. At the majority of patients a - food that leads to their exhaustion is broken. characterises an asymptomatic current more often, the phenomena , pains behind a breast - or in a back are possible-, at chronic - break in a trachea, , development , a lung abscess. also at the majority of patients proceed , but can be shown by pains behind the bottom - part of a breast, , a nausea, vomiting, a reflex short wind-, palpitation, a bronchospasm, symptoms a - gullet and .

Hernias Allocate Diaphragm Apertures In Separate - Group

Hernias allocate diaphragm apertures in separate - group as they arise most often, have features - of an anatomic structure, clinical displays and demand certain principles of treatment (the section "Hernias diaphragm apertures" see). Describe separate cases of rare hernias of other natural apertures of a diaphragm (a crack of a sympathetic nerve, an aperture - of the bottom hollow vein). Clinic and diagnostics: occurrence and degree - of expressiveness of symptoms hernias depend on character of the moved belly bodies in a pleural cavity, their volume-, degree of filling of the moved hollow bodies, and their excess in the field of hernial gate, degree of a collapse of a lung and displacement , the sizes and the form of hernial gate. Symptoms: gastroenteric, legochno-warm and the general. The factors leading to increase of intrabelly pressure, strengthen expressiveness of symptoms of disease in connection with - increase in a contained hernial bag. Patients complain of feeling of weight and a pain in areas, a thorax, , a short wind and the palpitation arising after plentiful food intake.

Treatment - Surgical - Good-quality Tumours Of A

Treatment - surgical - good-quality tumours of a belly wall also make level-by-level mending of a wound Malignant tumours of a belly wall mostly happen secondary (metastasises of a cancer of a stomach in navel area, metastasises , etc.) STOMACH HERNIAS Hernia (hernia) name interiors through natural or pathological apertures from a cavity - normally occupied with them, under covers of a body or in other cavity. Distinguish external and internal hernias of a stomach External hernias of a stomach is an internal together with from a belly cavity through artificial apertures of a belly wall hypodermic at preservation of integuments. Internal hernias of a stomach are formed in a cavity at penetration of interiors into pockets . Unlike an external hernia of a stomach at - occurs an internal without through the damaged belly wall under a skin (a hypodermic event-portable radio set) or outside (external ). Loss of interiors - name body outside through a natural aperture (for example, loss of a rectum, a uterus).

The External (superficial) Aperture The Channel Is Formed

The external (superficial) aperture the channel is formed by legs an external slanting muscle of the stomach, one of them is attached to - , another - to to an union Size of an external aperture the channel is various In cross-section it happens 1,2 - 3 sm, in - longitudinal - 2,3-3 the external aperture the channel slightly less, than at men see At women. Internal slanting and cross-section muscles of a stomach in . Areas are difficultly separable from each other. This muscular layer, settling down in a fillet - sheaves, approaches to seed and it is thrown through it, forming the different form and size the Border interval an interval: from below - a sheaf, from above - edge of internal slanting and - cross-section muscles of a stomach, from the medial party - external edge of a direct muscle of a stomach. The pahovyj interval can have , or the triangular form. The triangular form an interval testifies to weakness areas Cross-section in areas in two places it is strengthened by fibres on lateral edge of a direct muscle of a stomach goes ligamentum Henle.

Sliding Hernias Of A Thick Gut Happen At

Sliding hernias of a thick gut happen at slanting hernias, and a bladder at straight lines hernias is more often. Sliding hernias make 1 - 1,5 % of all hernias. Sliding hernias on the occurrence mechanism can be congenital and got. At congenital sliding hernias bodies (for example, the thick gut, a bladder) under the influence of the various reasons, sometimes since the period, gradually can some departments which have been not covered - to go down or as though to slide off on friable to internal hernial collars, to leave a belly cavity and to become a component hernial without a hernial bag. The got sliding hernias arise owing to - mechanical tightening adjacent to it of segments of a gut or a bladder, deprived of a serous cover. The sliding hernia of a thick gut has no symptoms. Usually it is the big hernia with wide hernial collars at persons of elderly or senile age. Diagnostics is helped by radiological research of a thick gut . At sliding hernias of a bladder of patients can - disturb frustration or in two ' | reception.

In A Medial Corner Of A Wound File

In a medial corner of a wound file - edge vaginas of a direct muscle of a stomach to - bones in area . Seed - stack on the formed muscular wall. Thanks to imposing of deep seams there is a restoration weakened - back the channel and narrowing - of its internal - aperture till the normal size. Edges an external slanting muscle of a stomach sew over seed edge in edge. Thus reconstruct a forward wall the channel and external a ring In some cases, especially at high a triangle, after sewing together of internal slanting and cross-section muscles with - a sheaf there is a considerable tension of seams that - promotes their procutting and hernia relapse In such cases - it is expedient to spend a cut of a vagina of a direct muscle of a stomach (operation the Poppy-blowing - Venglovsky). Way Kukudzhanova. It is offered for direct and difficult forms hernias After deep rings - impose seams between a vagina of a direct muscle of a stomach and - Cooper's sheaf-, from to a case - vessels In case of an outlined tension before setting - of seams in medial department of a vagina of a direct muscle do - slanting a cut in length 2 - 2,5 sm Then the connected - sinew of internal slanting and cross-section muscles together with top and bottom edges cross-section - file to to a sheaf the Latest seam impose at medial edge of a deep aperture the channel.

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.