Long Inflammatory Process Can Lead To Cicatricial Changes

Long inflammatory process can lead to cicatricial changes in a gullet, its shortening and development or progressing of a hernia to food of a water aperture - of a diaphragm. Gullet punching at usually does not happen. The diagnosis establish at presence at sick characteristic symptoms of disease, the data - of radiological research - and . Radiological - research allows - to find out zheludochno-pishchevodnyj a reflux, especially - at research of patients - and a prone position, . (a smoothness, or deformation of folds of a mucous membrane, local or a thickening the walls, insufficient elasticity of a wall of the amazed - site, narrowing of a gleam of a gullet, etc.) At - mark various degree and prevalence - inflammatory changes of a mucous membrane of a gullet: 0 stage _ a - normal mucous membrane; I stage - not merging defects of a mucous membrane; II stage - merging, but not circular defects, III stage - circular ' that cover; IV stage - complications illnesses (ulcers, , a short gullet, ' ).

After A Section Of A Restraining Ring Investigate

After a section of a restraining ring investigate - contents of a hernial bag. At viability preservation the dropped out - body set in a belly cavity, at irreversible - changes - . Defect in a diaphragm take in. HERNIAS OF THE APERTURE OF THE DIAPHRAGM Hernias can be congenital and got. Allocate sliding (axial) and hernias - diaphragm apertures. Sliding hernias. The kardialnyj department of a stomach located -, moves above a diaphragm on an axis of a gullet and takes part in formation of a wall of a hernial bag. Sliding hernias on classification. V.Petrovskogo and . N.Kanshina subdivide on , , and huge (subtotal and total - gastric) at which occurs a stomach in a chest - cavity. The sliding hernia can be fixed and - unstable. Besides, allocate the got short gullet ( I degree is located over a diaphragm at level of 4 sm, above 4 sm - II degree) and a congenital short gullet (a chest stomach). On to the factor sliding hernias can be , and mixed. The major importance - in development of the got sliding hernias diaphragm apertures has the mechanism arising at reduction of longitudinal muscles of a gullet as a result of reflexes from a stomach and other bodies at a stomach ulcer, a cholecystitis and other diseases.

At Research Mark Tone Decrease , Infringement -

At research mark tone decrease , infringement - a type gullet , zheludochno-pishchevodnyj a - reflux which also can be confirmed by the data rN-metrii (decrease to 4,0 and more low) (a sm technique in section "Special methods of research"). Treatment: paramount action is treatment of the basic disease creating conditions for zheludochno-pishchevodnogo of a reflux (a hernia diaphragm apertures, pi-loroduodenalnyj a stenosis, ). Conservative treatment is directed on reflux decrease, reduction of displays -, the prevention of increase of intrabelly pressure. The patient - recommend to avoid the positions of a body facilitating occurrence - of a reflux, to sleep with highly raised headboard of a bed. Depending on degree appoint mechanically and chemically sparing diet (table No 1, 16, 1 on Pevzneru). A food should be frequent (4 - 6 times a day), last food intake for 3 - 4 to a dream. Appoint , enveloping-, astringents, , , preparations, sedative, means, vitamins. At bleedings and spend therapy, at stenoses - .

However At The Majority Of Patients Of A

However at the majority of patients of a pain arise at overflow of a gullet and disappear after or passages - of food to a stomach. Some patients have attacks spontaneous support a breast as painful crises Similar pains observe in a disease initial stage, sometimes in addition before development and which not always - act in film atropine or nitroglycerine is more often - that allows to assume - their communication with progressing dystrophic process in a nervous texture of a gullet. Pains on an empty stomach or after vomiting are is more often caused and act in film food intake. An eructation air, the nausea, the raised salivation, burning on the gullet course, an unpleasant smell from a mouth also - are caused . At patients both with sharp, and with the gradual beginning of disease - in due course symptoms progress: amplifies , arises is more often. Many patients hesitate of the lack, become closed, painfully sensitive. The - most frequent complication of disease is stagnant which arises at a long delay of food weights in a gullet.

Distinctive Signs From Infringements Are Resulted In 6.

Distinctive signs from infringements are resulted in 6. Treatment: clearing of a thick gut of contents. At hernias it is necessary to try to keep a hernia in the set condition then it is easier to achieve restoration intestines. Apply small enemas with a - hypertensive solution of chloride of sodium, with glycerine or repeated siphon enemas with deeply entered probe to guts. Application of a depletive as overflow of a resulting loop by contents can cause transition in the form of infringement of a hernia is counter-indicative. can owing to in hernial collars of a taking away loop to pass in the form of infringement of a hernia. Signs intestinal impassability accrue. The belly-ache amplifies, gets character, vomiting becomes frequent. Further owing to overflow in weights of the gut which are in a hernial bag, occurs hernial collars of all loop of a gut and it . There is a mixed form of infringement of a gut. From this point on there are signs - impassability of intestines. The infringement of the big epiploon causes a constant pain in the field of hernial .

Owing To Mucous Membrane Damage The Intestinal Wall

Owing to mucous membrane damage the intestinal wall becomes nontight for microbes that conducts to peritonitis development. There can be a punching of a resulting loop in area furrows. In a taking away loop of the restrained gut of infringement krovo arise throughout 10 - 15 see Kinds of infringements of hernias and their recognition Clinical displays of infringement of a hernia depend on the form of the infringement, the restrained body, time last from the moment of infringement by the Basic symptoms of infringement of a hernia are a pain in the field of a hernia and a hernia which were earlier freely set. Intensity of a pain the various. The sharp pain can cause a faint, a state of shock Local signs of infringement of a hernia, hernial is sharply painful at , dense, strained. a push it is not possible to reveal a symptom. At it is defined if the hernial bag contains an epiploon a bladder, "hernial water". The perkutornyj sound happens if in a hernial bag there is a gut containing gas.

Early Reception Of Mixture And Food As Though

Early reception of mixture and food as though carries out "soft" a gullet. Formation of hems is interfered also by appointment (, , etc.) Which detain development and reduce inflammatory changes in a gullet. Now carrying out early (with 9 - 11th day) a gullet during 1 - 1 1/2 in a combination to hypodermic introduction or during 2 is recognised expedient. Too early, before this term begun gives opposite effect, causing an aggravation of inflammatory process in a gullet and scarring strengthening. Before the beginning it is necessary to make - which will allow to establish burn degree, absence fabrics. a gullet it is unsafe and can become complicated its punching with development purulent and a pleurisy, therefore he should be spent carefully. Hyperbaric oxygenation is applied to preventive maintenance of cicatricial stenoses of a gullet which reduces depth of a zone , delimits , promotes clarification to a surface and causes it by the end of 1st month. suppresses formation of a connecting fabric that leads to development more friable, thin and a gullet hem.

RARE SPECIES OF HERNIAS OF THE STOMACH Hernias

RARE SPECIES OF HERNIAS OF THE STOMACH Hernias a shoot are formed in the presence of defects in it. Through crevices and apertures in a shoot can be stuck out as , and the Diagnosis it is possible to put true hernias on the basis of the found out consolidation in area a shoot, defect presence in a shoot and the data a shoot. Treatment: the surgical Delete a hernial bag and a shoot of the Hernia semilunar lines are localised on a line connecting a navel with top forward of the bone at a place of transition of muscular fibres of internal slanting and cross-section muscles of a stomach in a stretching. Treatment: the surgical. At small hernias hernial gate close - by suture; at the big hernias after sewing together of muscles it is necessary to create . Lumbar hernias. Weak zones of lumbar area are the triangle - of Peti and an interval of Lesgafta - Grjunfelda. The triangle of Peti is formed by lateral - edge of a wide muscle of a back, back edge of an external slanting muscle of a stomach the triangle basis the comb bones is.

In Cases Heavy A Reflux-ezofagita Make Or Transpleural

In cases heavy a reflux-ezofagita make or transpleural with a stomach in a chest cavity. Congenital insufficiency treat conservatively. Usually eventually there comes function normalisation . GULLET DAMAGES Gullet damages divide on internal (closed) from outside a mucous membrane and the external - necks (opened) at - getting wounds and a thorax. Internal damages of a gullet are possible during - carrying out of diagnostic and medical actions: at -, a gullet, . There are gullet wounds from within at hit in it of foreign matters (see "Gullet foreign matters"). gullet walls arise at a long finding in it of probes, from pressure or tubes. Punching of a wall of a gullet can occur at its various diseases: tumours, an ulcer, chemical burns. At an irradiation of malignant tumours of damage of a gullet arise owing to tumour disintegration. Stupid traumas of a neck, thorax and stomach can lead to infringement of a food and walls of a gullet as a result of its squeezing between a breast and bodies of vertebras Thus often mark damage of the next bodies the Straight line to a gullet trauma can occur during operations on bodies and lungs.

Bottom Possesses "unilateral - Passableness". Pressure Suffices For

Bottom possesses "unilateral - passableness". Pressure suffices For advancement of a contained gullet through penalties-diju in 4 mm hg, in a return direction movement is possible only at increase of pressure to 80 mm hg In norm pressure in the field of physiological above, than in a gullet and a bottom of a stomach, and is equal on the average 22 - 28 mm hg It are caused by the tonic reduction of circular muscular - fibres interfering zheludochno-pishchevodnomu a reflux. The - greatest value has a part physiological - which interferes with a reflux at a considerable difference of pressure in a chest and belly cavity. The normal anatomic arrangement of a gullet in relation to a diaphragm is very important for correct functioning of the closing mechanism physiological . Hit gastric - contained in a gullet is interfered also presence of "the mucous socket" in the field of pishchevodno-gastric , by an acute angle of Gisa, presence of the valve of Gubarev - folds of a mucous membrane at a junction of a gullet with a stomach, a switching reflex on at irritation of a mucous membrane department of a stomach food, etc.

At Disintegration And Knots The Macroscopical Picture Differs

At disintegration and knots the macroscopical picture differs from a picture of an ulcer cancer a little. The ulcer type of a cancer of a gullet meets approximately at 30 % of patients. In an initial stage of disease represents a small knot in thickness of a mucous membrane which quickly is exposed . The tumour grows mainly along a gullet, amazing all layers of its wall and extending on surrounding bodies and fabrics. Edges of the formed ulcer dense, the bottom is pruinose is dirty-grayish colour. Tumour early in and the remote lymph nodes. In a wall of a gullet throughout 5 - 6 sm from tumour edge often develop cancer . The infiltrativnaja form of a cancer of a gullet makes about 10 %. The tumour develops in deep layers of a mucous membrane, quickly amazes a layer and extends mainly on a gullet circle. Expanding, the tumour grasps all layers of a wall of a gullet, its gleam. On length the tumour seldom occupies more than 3 - 4 sm, is characterised by plentiful development -, slowly .

At A Congenital Short Gullet And Insufficiency There

At a congenital short gullet and insufficiency there is a reflux-ezofagit, the ulcer, and then a gullet develops , - frequent complication is the pneumonia. The diagnosis congenital anomaly of development of a gullet - establish by means of radiological research at which into a gullet gleam on thin enter 1 - 2 ml . Research allows to find out the blind end - of a gullet, level of its arrangement, extent and narrowing size, gullet expansion, presence - of the message of a gleam of a gullet with bronchial tubes or a trachea. At gullet doubling mark an additional shade with the accurate contours, adjoining a shade and pushing aside a gullet. At a short gullet it has no bends, and the stomach part is located - above a diaphragm. Insufficiency is shown zheludochno-pishchevodnym by a reflux of contrast substance during research. The big role in diagnostics of developmental anomalies - of a gullet play ezofago - and . Treatment: features of surgical treatment a - gullet are defined by its kind.

Apply : Allocate From Surrounding Fabrics To A

Apply : allocate from surrounding fabrics to a neck, make , it and take in an aperture in a gullet wall. At considerable muscular defect or an atrophy - of muscular fibres of a gullet make plastic restoration of its wall by a rag of a diaphragm, a pleura. apply only at the small sizes . after operation makes 1 - 1,5 %. GOOD-QUALITY TUMOURS AND THE GULLET Good-quality tumours of a gullet and are observed seldom. Pathological anatomy: tumours in relation to a gullet wall can be and . On a histologic - structure of a tumour divide on ( - polyps, papillomas) and (, , fibromas, , , , , , etc.). Vnutriprosvetnye tumours settle down more often in or gullet department, - in - its bottom two thirds. From good-quality tumours - of a gullet the most frequent kind is , - developing of smooth muscular fibres. The place second for frequency among good-quality - gullet formations occupy (, , ). represent the thin-walled - formations containing a light viscous liquid. The wall consists of a fibrous fabric with an impurity of smooth muscular fibres and a cartilage.

At A Thrombosis Of Venous Knot The Big

At a thrombosis of venous knot the big hypodermic vein tie up and cross at a place of its confluence of a deep vein of a hip to warn and thrombosis distribution on a deep vein of a hip. A trombirovannuju vein . Sudden infringement of earlier not coming to light hernias. On a belly - wall in typical for formation of hernias sites can remain after a birth (predsushche-stvujushchie hernial bags). More often such preprepared hernial bag in areas is brjushinno-pahovyj a shoot the Reason of sudden occurrence of a hernia and its infringement sharp increase of intrabelly pressure (- considerable physical pressure, strong cough, ) is-. In the anamnesis patients do not have instructions on signs before - existing hernias: , painful sensations in the places typical for localisation of hernias. The basic sign of suddenly arisen restrained hernias - acute pain occurrence in typical places hernias. At sudden occurrence of an acute pain in areas, in the field of the femoral channel, in a navel it is necessary - to define at inspection - of the patient at the most painful sites corresponding to hernial collars.

Small Hernias With The Narrow And Rubtsovo-changed Neck

Small hernias with the narrow and rubtsovo-changed neck of a hernial bag are restrained more often, than the big hernias. The infringement is not destiny only a hernia long existing. The hernia at occurrence can prove infringement at once. Frequency of separate kinds of hernias at adult patients with the restrained hernias: hernias - 43,5 %, postoperative hernias - 19,2 %, umbilical hernias - 16,9 %, femoral hernias - 16 %, hernias of a white line of a stomach - 4,4 %. Any body can be restrained, the small intestine and the big epiploon are more often restrained. On the occurrence mechanism distinguish , and mixed, or combined, infringement. The Elastichesky infringement occurs at the moment of sudden - increase of intrabelly pressure at physical activity, cough, , etc. Thus there comes a restretching of hernial gate therefore in a hernial bag leaves more than usually an internal. Returning of hernial gate in a former condition leads to infringement of contents of a hernia. At infringement the left.