If The False Infringement Is Not Distinguished And

If the false infringement is not distinguished and operation concerning a hernia is undertaken, it is important to estimate correctly at this diagnostic stage contents of a hernial bag (a condition of intestinal loops, character ). At the slightest suspicion on an acute disease of bodies of a belly cavity (in a hernial bag a little changed loop of a gut, purulent or ) it is necessary to make median for revealing of a source of a peritonitis. Treatment: the restrained hernia is the indication to - emergency operation. It is necessary to eliminate infringement and to find out viability of the restrained bodies. Operation spend to some stages The first stage - a level-by-level section of fabrics to and an exposure of a hernial bag. The second stage - opening of a hernial bag make - not to damage cautiously - intestines loop, skintight to a wall of a hernial bag. At sliding and femoral hernias there is a danger of damage of a wall of a thick gut or a bladder. Having opened a hernial bag, delete "hernial water".

In A Duodenal Gut Digestion Of All Food

In a duodenal gut digestion of all food - components is carried out-. The duodenal gut has value in regulation functions of a stomach, a pancreas, a liver, in activity coordination the device. Stomach and duodenal gut, participating in a metabolism, provide homeostasis regulation. Being the main link in hormonal - system of a gastroenteric path, the stomach and a duodenal gut influence diverse functions of various systems of a human body. SPECIAL METHODS OF RESEARCH The analysis of gastric juice. To research of secretion of gastric - juice apply stomach sounding by a thin probe. Before the research beginning through a probe take the - contents which have accumulated in a stomach-. Investigate "" secretion during the interdigestive - period and secretion after - stimulator introduction-. Secretion zhel-udochnogo juice is on an empty stomach carried out mainly as a result of influence on the device - of a stomach of wandering nerves, therefore on indicators "" secretions can be judged a condition of a tone of wandering nerves indirectly.

Often Mark - Gurgle And Rumbling In A

Often mark - gurgle and rumbling in a thorax on the hernia party, short wind strengthening in horizontal position. After meal there is a vomiting - by the accepted food that brings simplification. At a stomach, - accompanied by a gullet excess, develops paradoxical (the firm food passes better liquid). Direct dependence of expressiveness of clinical symptoms on degree of filling of a gastroenteric path has the big diagnostic value. Infringement hernias characterise sharp pains in a corresponding half of thorax or in areas, in a back, a shovel. The infringement of hollow body - can lead and punching of its wall with development . To suspect a hernia it is possible at presence in the - anamnesis of the trauma, listed above complaints, reduction of mobility - of a thorax and smoothing of intercostal intervals by the defeat party, a stomach at big it is long existing hernias, definition or over a corresponding half of the thorax, changing - intensity depending on degree of filling of a stomach and an intestines-, auscultation an intestines or splash noise in this zone at simultaneous easing or a total absence of respiratory noise, dullness displacement in not amazed - party.

Revealing Of Noise Of Splash Of A Liquid

Revealing of noise of splash of a liquid in a stomach is reached by drawing of short pushes on a belly wall tips of the semibent fingers. Noise of splash of the liquid, defined on an empty stomach, testifies to infringement of evacuation from a stomach (a stenosis of an exit from a stomach, a stomach). Noise of splash of a liquid in intestines can be found out at intestinal impassability. At a stenosis aorta department listen to noise in a point at once below a navel and on 2 sm to the left of an average line. Manual research of a rectum. Define a tone , gut contents (, slime, blood), a condition glands. At manual research of a rectum tumours and gut departments, in a small basin, cancer metastasises on (metastasises of Shnitslera), tumours guts, tumours of a uterus and can be revealed. At sharp diseases of bodies of a belly cavity manual research of a rectum gives the important information. Morbidity at pressing on rectum walls specifies in inflammatory changes prjamokishechno-matochnogo deepenings ( a pocket-) and bodies of a small basin.

To Conduct Research It Is Necessary Very Cautiously

To conduct research it is necessary very cautiously in connection with punching possibility . Treatment at the small sizes , absence of complications, absolute contra-indications to surgical - treatment spend the conservative therapy directed on - preventive maintenance of a delay of food weights in and reduction of possibility of development . The food should be - high-grade, mechanically, chemically and thermally sparing. The patient recommend to eat well crushed food After meal - it is necessary to drink some drinks of water, to accept the position promoting . At the big sizes sometimes there is a necessity for cavity washing -. Indications to surgical treatment a gullet: complications (punching, , a bleeding, a - gullet stenosis-, a cancer, development of fistulas), big , complicated at least a short-term delay in them of food weights, a long - delay of food in irrespective of its sizes. Depending on localisation choose operational - access: at glotochno-pishchevodnyh - cervical, at - right-hand , at - link sided .

In Umbilical Area A Radiant Arrangement Expanded Hypodermic

In umbilical area a radiant arrangement expanded hypodermic veins ("a head of a jellyfish") observe at difficulty - of outflow of blood on to a vein. In departments of a stomach occurrence expanded venous between - femoral and bottom a vein testifies to difficulty of outflow of blood on system of the bottom hollow vein. Observe displacement of a belly wall during the breath certificate. Absence of displacement of any area or all belly wall during breath happens at pressure of muscles as a result a reflex arising owing to irritation . Check active a stomach (a symptom - of Rozanova). To the patient suggest to inflate a stomach, and then to involve it. At sharp inflammatory processes in a belly cavity patients - cannot inflate a stomach because of sharp strengthening of pains. At the - inflammatory processes localised (-, a pleurisy), accompanied sometimes pains in the field of a stomach and pressure of muscles of a belly wall, and stomach retraction probably. The symptom of Rozanova - gets value for difference of sharp inflammatory processes of a belly cavity from processes.

Pharmacological Test - With And Is Negative. In

Pharmacological test - with and is negative. In patients with often find out hernias - diaphragm apertures, the combination of disease with a gullet is possible. Complication are , attacks of a reflex stenocardia. The disease current long, from time to time that - amplifies, disappears almost completely. At a secondary (reflex-) dyskinesia of a gullet its symptoms usually pass at - treatment of the basic disease. Work capacity, as a rule, is not broken. Treatment: should be directed on normalisation of a motility of a gullet. Complex treatment of patients with (primary) includes appointment of a sparing diet-, and sedative preparations, vitamins, - physiotherapeutic procedures. In the absence of a positive effect - from conservative therapy make (as operation of Gellera) to level of an arch of an aorta. Insufficiency . Disease is connected with - infringement of switching function physiological that leads to occurrence zheludochno-pishchevodnogo a reflux and to development of functional and organic changes of a gullet.

Patients Have A Painful Thirst As A Result

Patients have a painful thirst as a result , . At a blood test mark , shift - formulas to the left, increase , increase , hypo- and . In hard cases it is observed -, and , metabolic -. At an accompanying burn of a throat and vocal chords can be the voices, complicated-breath, . In - hard cases toxic defeat bodies (sharp hepatic and nephritic insufficiency) develops. The poisoning with an acetic essence can cause development intravascular . Patients have a jaundice, urine gets colour of meat slops, it is marked , , the anaemia accrues. As a result at patients the pneumonia can develop . At direct damage of vessels in the field of a burn there are early - bleedings. Sometimes on 5 - 7th day develops a psychosis (a mental trauma, stress, a pain, burn ). II stage - a stage of "imaginary well-being" - proceeds with 7 about 30 days. By the end of 1st week tearing away gullet fabrics begins. than liquid food becomes slightly more free, bleedings are possible. At deep there is a punching of a gullet with development - of symptoms , , pleurae, a pishchevodno-bronchial fistula.

These Substances Accept For The Purpose Of -

These substances accept for the purpose of - suicide or by mistake. Heavy damage of departments - of a digestive path happens also at reception of a solution of permanganate , , acetone. The mechanism of their action on a fabric other, than acids and alkalis. So, permanganate and operate on a fabric as oxidizers. At chemical burns of a gullet there can be simultaneously - burns of a mouth, a throat, a hypostasis of lungs, sharp respiratory - insufficiency. It happens at reception of acetic acid and liquid ammonia owing to them and at influence of steams of the concentrated acids and alkalis. Pathological anatomy: the most expressed changes arise in places of physiological narrowings - in - area , glotochno-pishchevodnogo , at level tracheas, over physiological . As a result of a chemical burn the oral cavity mucous membrane, drinks, a gullet, a stomach is damaged first of all. After and a mucous membrane hypostasis quickly comes - fabrics. By the end of 1st week tearing away sites from subject fabrics and formation superficial or deep begins.

The Main Task Of A "flowing" Method -

The main task of a "flowing" method - maintenance - of sufficient outflow separated of a wound Use - of powerful modern antiseptic tanks (, ) allows - to achieve utter annihilation microflora - effectively enough washing of wounds by solutions , - boric acid, a sodium hydrocarbonate. Advantages of the given - method : technical simplicity and availability. The method of active surgical treatment of sharp purulent - diseases includes probably early closing surfaces - by means of the primary, primary delayed, early secondary seams. The basic condition for suture on a purulent wound - is carrying out of high-grade surgical processing of a purulent wound or clarification by its chemotherapeutic means. The usual - central seam stitched through all layers of a wound, provides good adaptation of edges and wound walls. Carrying out (the general and local) should be a necessary component of complex treatment of patients. The antibiotic choice should be carried out taking into account sensitivity - to it of the activator.

Results Of Research Document By Means Of Roentgenograms,

Results of research document by means of roentgenograms, videorecording, . To specification of prevalence of tumours of a gullet and - their differential - diagnostics from formations apply (radiological research of bodies , contrasted by means of entered in - gas). To an estimation of a condition of walls of a gullet apply (radiological research at simultaneous - a gullet air in conditions ). If necessary resort to a tomography, allows to examine a gullet mucous membrane on all extent, precisely to make by means of special nippers from suspicious sites, to make dabs for cytologic research. Remote slices of a fabric subject to histologic research. rigid - apply with the medical purpose to extraction of foreign matters and for forced a - gullet. The important additional method of diagnostics of functional and some organic diseases of a gullet ( , , hernias apertures of a diaphragm-, etc.) is (graphic record of reductions and a tone of walls of a gullet and it ). At differential diagnostics of organic and - functional narrowings of a gullet apply tests with nitroglycerine, , .

Efficiency Judge Not Only On Subjective Sensations Of

Efficiency judge not only on subjective sensations of the patient, but also according to radiological and - researches During time and in a near time after it development of complications (rupture of a gullet with development , a sharp pishchevodno-gastric bleeding), - urgent measures demanding - acceptance is possible-. To early complications carry also insufficiency with development heavy a reflux-ezofagita In the nearest terms after excellent and good results mark almost at 95 % of patients, however in some years at 30 - 70 % of patients come the relapse demanding a refresher course of treatment. Operative treatment is symptomatic and is directed on elimination of impassability of pishchevodno-gastric transition. Indications to it are 1) impossibility to spend , 2) absence of therapeutic effect after repeated courses , 3) early the diagnosed ruptures of a gullet arising during expansion -, 4) expressed , developed after a restretching and not giving in to conservative therapy and , 5) sharp expansion, a S-shaped curvature - of a gullet in a combination to cicatricial changes in .

Or A Forward Wall Of A Rectum Arises

or a forward wall of a rectum arises at a congestion in a cavity of a small basin inflammatory at a peritonitis or blood at a bleeding ". SHARP STOMACH Sharp stomach (the reasons, the basic clinical signs, - diagnostic methods at different investigation phases of the patient). The term "a sharp stomach" designate clinical , developing at damages and sharp diseases - of bodies of a belly cavity at which it is required or the urgent surgical help can be demanded. The first medical inspection of the patient is often made out of a hospital (in-home or in polyclinic). A problem of primary elementary diagnostics is recognition of a dangerous situation - and necessity of urgent surgical treatment. At a sharp stomach the forecast worsens eventually, therefore the doctor is obliged to hospitalise quickly the patient in profile establishment - where in the near future to the patient necessary diagnostic and medical actions should be carried out. Even at suspicion on a sharp stomach it is necessary to hospitalise the patient urgently-.

Forward The Hernia At Women Begins From Puzyrno-matochnogo

Forward the hernia at women begins from puzyrno-matochnogo deepenings and leaves in the big sexual lip in its central part. Back the hernia begins at men from puzyrno-prjamokishechnogo deepenings , at women from matochno-prjamokishechnogo deepenings, passes from an intersciatic line through cracks in a muscle lifting back pass, and leaves in sedalishchno-prjamokishechnoj hollows. Back a hernia, leaving in hypodermic , settles down either in front, or behind apertures. Promezhnostnye hernias are more often observed at women. The bladder, female genitals happen contents of a hernial bag. At diagnostics about-mezhnostnyh hernias localisation hernial - has essential value-. Forward the hernia at women is necessary for differentiating with a hernia which also leaves in the big sexual lip. Manual research through a vagina helps diagnostics, hernial hernias can be probed between a vagina and a sciatic bone. Sciatic hernias, can leave through the big or small sciatic apertures. Hernial it is located under the big buttock muscle, sometimes leaves from under its bottom edge.

If To 3 - To 5 Years Has

If to 3 - to 5 years has not come self-healings further independent the umbilical ring will not occur. Thus surgical treatment is shown. The indication to operation at earlier age are frequent partial infringements of a hernia, fast increase in the sizes of a hernia. Operation spend on stages: allocation and removal of a hernial bag, an umbilical ring a seam (on a method of Leksera) or the separate seams stitched for edges of defect in a longitudinal direction. At the big umbilical hernias - use a method of Sapezhko or Mayo (are described more low). During operation at children it is necessary to keep a navel as absence of a navel can put a mental trauma to the child. Umbilical hernias at adults make 5 % of all external hernias of a stomach. Development of umbilical hernias is observed at - women is more senior 40 years (80 %) more often-. The reasons of development of umbilical hernias: Congenital defects of umbilical area, repeated the pregnancy, proceeding without observance of a necessary mode, neglect physical exercises and gymnastics.