Ezofagotonokimografichesky Research At Patients With Functional - Infringements

Ezofagotonokimografichesky research at patients with functional - infringements of a motility of a gullet at carrying out of these tests registers normalisation gullet functions. To intensity definition zheludochno-pishchevodnogo a reflux apply rN-metriju by means of a special probe or a radio capsule which establish on 5 sm above . Into a stomach enter 300 ml 0,1 . Hydrochloric acid. At a pishchevodno-gastric reflux there is a sharp decrease and strengthening of a painful syndrome. CONGENITAL ANOMALIES OF DEVELOPMENT OF THE GULLET To congenital developmental anomalies of a gullet carry: a gullet total absence ( or full ), full - impassability of a site of a gullet , stenoses, fistulas, gullet doubling, a congenital short gullet, congenital (insufficiency) . Frequency - 1:1000 newborns. - a total absence of a gleam of a gullet on its any site or on all extent. In 40 % of cases it is combined with other developmental anomalies. During the first hours and days after a birth at newborns mark constant allocation of a saliva and slime from a mouth and a nose, there can be a strong cough, a short wind and as a result a contained gullet in respiratory ways.

Similarity To A Femoral Hernia Has - Expansion

Similarity to a femoral hernia has - expansion of the big hypodermic vein at a place of its confluence of a femoral vein. At such patients at vertical position of a body owing to - fillings of venous knot appears under - a sheaf which disappears in horizontal position. Difference of a femoral hernia from knot of the big hypodermic vein are the signs resulted in tab. 5. Table 5: Diagnostic signs of a femoral hernia and knot of the big hypodermic vein Priznakianevrizmatichssky knot big hypodermic a hernia Skin condition over Varikoznoe expansion of veins Symptom a push , dark blue colour Is available for the majority of patients on a shin Sensation a blood current Vascular noise and symptom colours No It is defined It is defined nothing Swelling occurrence under a sheaf in vertical position of the patient can be caused distribution an abscess on a course of a lumbar muscle on a hip at a tuberculosis of lumbar department of a backbone. The natechnyj abscess at pressing decreases in sizes, as well as a hernia.

The Cut Should Be Made With The Account

The cut should be made with the account anatomo-topogra-ficheskoj characteristics of localisation of a hernial phlegmon. Over a hernia dissect fabrics. A hernial bag open-, delete purulent . Hernial gate cautiously make cuts so to take the restrained gut and its blind ends of resulting and taking away pieces. After removal of the restrained gut separate a mouth and a neck of a hernial bag from hernial gate. A plasticity of hernial gate do not make. On edges of hernial gate impose some seams for the purpose of the prevention in the postoperative period . Further delete a hernial bag together with the changed fabrics (at umbilical, hernias it probably to make the uniform block). Surgical processing of the purulent centre finish - wounds. The punched drainage stack on a wound bottom, the drainage ends deduce from a wound through healthy fabrics. Resulting - end of a drainage connect to system from blood transfusion with the antibacterial preparations, taking away end connect to a tube lowered in bank with an antiseptic tank Through a drainage - carry out long constant "flowing" washing of a wound by antibacterial preparations.

If Between The Allocated Ends Of A Gullet

If between the allocated ends of a gullet does not exceed 1,5 sm, impose direct the end in the end. At considerable the gullet ends a part it deduce on a neck in a kind , impose for a food of the child, subsequently - make . The choice of a kind of operation at a congenital stenosis of a gullet depends - on extent of narrowing. At narrowing to 1,5 sm make a longitudinal section of a wall of a gullet with cross-section sewing together of edges of a wound over . If the site of narrowing does not exceed of 2,5 sm on extent, performance of a resection of a gullet with the end in the end is possible. At considerable extent of narrowing it is shown . At localisation of narrowing in the field of physiological make mio-tomiju (operation of Gellera) with or plastic arts a diaphragm rag. Treatment traheo - and fistulas consists in crossing a course and the formed defects in both bodies At gullet doubling is shown or a resection a site. At a congenital short gullet and absence of complications spend conservative treatment.

The Top Horizontal Line Connect The Lowest Points

The top horizontal line connect the lowest points of edges; the bottom horizontal line spend through the highest points of crests . Thus three - areas are allocated-: top - (regio epigastrium), average - (regio meso-gastnum) and bottom - (regio hypogastrium). The lines spent along external edges of direct muscles of a stomach, divide - each of these areas into three areas. Projections of bodies on a stomach wall. In actually area the stomach, a small epiploon, a part of a duodenal - gut and a pancreas, the left share of a liver and a part of the right share of a liver, a bilious - bubble, an aorta, an artery with arteries departing from it, a vein, the bottom hollow vein are projected---. On - area are projected: the right share of a liver, a bilious bubble, a part of a duodenal gut, a - hepatic bend guts, the top department of the right kidney. On left area are projected: a stomach part, a spleen, a pancreas tail, a bend guts, the top department of the left kidney-. On umbilical area - are projected: small intestine loops, a pain of that an epiploon, cross-section a gut, an aorta, top an artery with its branches, the bottom - hollow vein On the top department of this area are projected: gland and the big curvature of a stomach (especially at it ) On the right lateral area are projected: ascending - a gut, a part of loops of a small intestine, the right kidney with .

Symptoms: A Pain In The Areas, Amplifying After

Symptoms: a pain in the areas, amplifying after food intake, at increase of intrabelly pressure. Occurrence of pains in patients with hernias of a white line of a stomach - explain or time infringement of a hernia, or a tension - of a stomach an epiploon fixed to a hernial bag, or pressure - upon nerves (a hernial bag). At research of the patient find out dense painful - formation in the field of a white line of a stomach. At hernias sometimes it is possible to probe hernial gate. Some patients of a hernia proceed . Various diseases of an internal, such, as a stomach ulcer of a stomach or a duodenal gut, a chronic cholecystitis, chronic , etc. In this connection the patient replying researches for revealing of diseases, sopro-zhdajushchihsja pains in areas should be conducted can accompany a hernia of a white line of a stomach. Treatment: the surgical. Operation consists in allocation - of a hernial bag, its removal and aperture closing in - by imposing a seam or separate central seams.

Physiological Value Of A Gullet Consists In Carrying

Physiological value of a gullet consists in carrying out of food of a cavity drinks in a stomach, carried out a reflex. Thus the important role in normal activity of a gullet belongs to a reflex of timely disclosing , coming in norm through 1 - 2 1/2 with the ambassador of a drink. The relaxation - physiological provides free receipt of food in a stomach under action waves. After passage of a food lump to a stomach there comes restoration of a tone bottom and closing . SPECIAL METHODS OF RESEARCH To diagnostics gullet disease apply - radiological research, , study impellent function. Contrast radiological research of a gullet with a - water suspension of sulphate of barium (at suspicion on punching with water-soluble contrast) spend at various turns of the patient round a vertical axis, in vertical, horizontal position or in position with the raised basin. Pay attention - to character of contours, elasticity, , -, ability of walls of a gullet, study a mucous membrane relief, examine areas of physiological narrowings.

In Group A Precancer Carry Gullet Papillomas. Patients

In group a precancer carry gullet papillomas. Patients with the given disease are subject to supervision with carrying out - repeated for microscopic diagnostics. Pathological anatomy: the gullet cancer develops - more often in places of physiological narrowings: the gullet mouth, at level tracheas, over physiological On frequency of defeat by a cancer on the first place is department (at 60 %) - at level of an arch of an aorta and the left main bronchial tube, on the second place-nizhnegrudnoj and gullet department (at 30 %), on the third - cervical and (At 10 %) On a macroscopical picture distinguish three basic forms of a cancer of a gullet, a central cancer (, ), ulcer, There are mixed forms of growth. Central forms make about 60 % of cancers of a gullet. These - tumours have growth, are presented by the growths - similar to a cauliflower, have more dark colouring, than a normal mucous membrane. The tumour is easily injured, - is subject to disintegration and constantly bleeds. Tumoral extends on and muscular covers.

It Is Necessary To Struggle With Adiposity And

It is necessary to struggle with adiposity and especially with a strong exhaustion after it as these pathological - conditions quite often favour to formation of hernias. At the - enterprises it is necessary to select correctly workers on a physical activity according to their forces and a state of health. The great value has early revealing of the people, suffering stomach hernias, and their direction on operation before development of complications. For this purpose it is necessary to spend population routine inspections, in particular schoolboys and persons of a pension age. HERNIAS Pahovye hernias make 80 - 90 % of other kinds of hernias. Among patients with hernias of the man make 90 - 97 %, and women - 3 - 10 %. More frequent occurrence hernias at men is connected with features of development and an anatomic structure areas at men. Pahovye hernias happen congenital and got. Embriologichesky data - lowering process begins With III month of pre-natal development of a germ - of a male In area rings is formed - brjushinno-pahovyj the shoot the next months pre-natal development occurs Further in the channel In the end of VI VII months start to fall in .

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 .