Survey Intestines, Free Gas In A Belly Cavity.

Survey intestines, free gas in a belly cavity. Survey emetic weights (a bile impurity), a chair (at blood in weights). Measurement . Laboratory researches the blood analysis (, , ). Early signs of a peritonitis occurrence of the constant belly-ache amplifying at cough, sensation of dryness in an oral cavity, pulse increase, local morbidity at and a stomach, occurrence of easy local pressure of muscles of a belly wall, . Early signs of an intraintestinal bleeding weakness, dizziness, pallor of integuments, pulse increase, decrease in arterial pressure, haemoglobin decrease, , a blood impurity in weights. Occurrence of signs of a peritonitis, bleeding in intestines is the indication to emergency operation Operation consists in , resections of the changed site of a gut to level of the kept sufficient blood supply in resulting and taking away intestinal loops. To the patient at whom at dynamic supervision signs of a peritonitis are not revealed, an intraintestinal bleeding, it is shown in a planned order with a plasticity of a belly wall in the field of hernial gate.

It Depends On A - Diaphragm Tone. Dynamic

It depends on a - diaphragm tone. Dynamic function of a diaphragm is caused by influence of a moving diaphragm at breath on lungs, heart and bodies of a belly cavity. Diaphragm movements carry out ventilation of lungs, facilitate - blue blood receipt - in the right auricle, promote to a blue blood from a liver, a - spleen and bodies of a belly cavity, to movement of gases in a gastroenteric path, to the certificate , . RESEARCH METHODS At it is possible to define level of an arrangement - of a diaphragm, to suspect moving of bodies of a belly cavity to the chest-. Radiological research is the basic method of diagnostics of damages and diaphragm diseases. The top - of the right dome of a diaphragm in front settles down at level of V edge, left - on one edge more low. At quiet breath diaphragm excursion is equal 1 - 2 sm, at forced reaches 6 see - High arrangement x diaphragm domes mark at - pregnancy, , a peritonitis, paralytic intestinal - impassability. High standing of one of diaphragm domes happens at , paralyses, a diaphragm relaxation, tumours, and liver abscesses, abscesses.

As Symptoms Of An Intra-belly Bleeding The Stomach,

As symptoms of an intra-belly bleeding the stomach, in the beginning local morbidity serve strained, increased in at , and then a stupid constant pain and development a shock. At damage of hollow body of the phenomenon of a peritonitis - traumas develop - not right after. For its development some time is required, therefore the patient should be under supervision of the doctor At suspicion on a peritonitis or a bleeding after a stomach trauma it is necessary to spend research at which it is possible to define a forward wall of a rectum and sharp morbidity at . From additional methods of research it is expedient - to use a laparoscopy and ultrasonic scanning of bodies of a belly cavity. At damage of an aorta or arteries - diagnostic value easing or absence of a pulsation on femoral arteries, has a shock. Additional method of diagnostics is research. DISEASES OF THE BELLY WALL Congenital umbilical fistulas develop as a result a zheltochno-intestinal channel (ductus omphalomesentericus) or an uric channel (urachus) At a zheltochno-intestinal channel in the field of a navel the fistula with intestinal is formed or mucous separated Sometimes through a fistula the - gut mucous membrane drops out-.

At - Suspicion On Defect Presence In Its

At - suspicion on defect presence in its wall owing to rupture or punching it is necessary to apply water-soluble contrast substances as a barium suspension, leaving through defect in a gullet wall in , it and does - the subsequent researches. Besides, it as a foreign matter promotes development of an infection of Jodsoderzhashchie water-soluble connections (, , etc.) . Easily - get through small defects in a gullet wall, not inflammatory reaction surrounding , are quickly soaked up Often researches happens enough for localisation and the sizes of a punched aperture In doubtful cases use under anaesthetic by means of rigid . Treatment, conservative (a food exception through a mouth, a prescription of antibiotics, a food of patients, etc.), spend - 1) to an establishment of the definitive diagnosis and at a delay of delivery of the patient to a surgical hospital, 2) at damages of cervical department of a gullet; 3) as addition to surgical treatment. Surgical treatment (radical and palliative) is shown at extensive damages of a gullet, presence of messages of its gleam with , a tree, a pleural cavity.

As A Result Of - Scarring And An

As a result of - scarring and an inflammation the gleam of a gullet in the field of narrowing has the wrong form. Over often is available expansion, arises - strengthened -. At - reveal presence , pockets, - hems. Both methods of research - allow to specify degree, localisation, extent of narrowing, its course, presence expansions-, a pishchevodno-bronchial - fistula. Treatment: the basic - method of treatment a gullet after a - chemical burn - is - which leads to proof - recover 90 - 95 % of patients Unlike early (with 9 - 11th day after a burn) later - spend for the purpose of expansion of already developed - narrowing of a gullet-. Begin - from 7th week. it is shown all patients with a gullet when it is possible to spend a metal conductor through narrowing. Contra-indications to buzhiro-vaniju: , a pishchevodno-bronchial fistula. For - achievement proof effect treatment is necessary for spending within many weeks and even months Apply: 1) "blind" through a mouth, 2) gullet expansion hollow plastic on a metal conductor; 3) under the control , 4) by a principle " endlessly"; 5) .

The Exception Makes Nephritic , At Which Patient

The exception makes nephritic , at which patient localises a pain with right or a body left-hand side. Finding out character pains, it is possible to judge the amazed layers of a wall of body. Burning is observed at inflammatory changes or - defects of a mucous membrane, it is caused by reaction of surrounding - fabrics to action . The pressure sense, overflow-, a swelling, reaching a dull ache, arises at a stretching - of deep layers of a wall of body. The vistseralnaja pain can have character of the attacks shown (intestinal, hepatic, nephritic). The shvatkoobraznaja pain, , is caused by the strengthened reduction of smooth muscles of hollow body, . to overcome an obstacle for its contents. At bad attacks of a pain of the patient it is uneasy, changes position, searches for a pose at which the pain would become less intensive. At morbidity is not clearly localised, expressed - slightly. During an attack the stomach is strained, between an attack be ill a stomach soft. The pain is accompanied by a nausea, vomiting, pallor, .

By Origin Distinguish The Congenital And Got Hernias.

By origin distinguish the congenital and got hernias. The got hernias divide into hernias from effort (owing to sharp increase of intrabelly pressure), hernias from weakness (at older persons at an atrophy of muscles, reduction of elasticity of a belly wall), the postoperative, traumatic artificial Depending on an anatomic arrangement of hernias distinguish , femoral, umbilical, , a shoot, lateral hernias of a stomach, lumbar, sciatic, apertures, . On a clinical current depending on a condition of interiors entering into a hernia I divide! Hernias on , , hernias with the phenomena , hernias with the phenomena of infringement, a hernia with the inflammation phenomena. Aetiology and : the Greatest number of patients happens to hernias among children aged till 1 year, then the number of patients gradually decreases to 10-year-old age after that - again increases and to 30 - to 40 years reaches a maximum At elderly and senile age also the increase in number of patients with stomach hernias is noted.

At Hernias All Patients Accept - Surgical Treatment

At hernias all patients accept - surgical treatment in connection with possibility of development of its infringement Operation consists in bringing down of belly bodies and sewing together of edges - diaphragm apertures behind a - gullet. At a combination hernias with insufficiency - supplement operation on Nissenu. At the restrained hernias of patients operate the same as at others hernias. DIAPHRAGM RELAXATION Diaphragm relaxation - diaphragms and its displacement together with adjacent bodies to it a belly cavity in chest-. The line of an attachment of a diaphragm remains on a usual place. The relaxation happens congenital (on soil or full diaphragm muscles) and got (more often - as a result of damage a nerve). The relaxation can be full (total) when all dome of a diaphragm (more often left is amazed and moved to a thorax), and partially (limited) at its any department (more often on the right). At a diaphragm relaxation occurs a lung on the party of defeat and displacement an opposite side, can arise cross-section and longitudinal a - stomach ( and departments settle down at one level), a bend of a thick gut.

Clinic And Diagnostics: The Limited Right-hand - Relaxation

Clinic and diagnostics: the limited right-hand - relaxation proceeds . At a link sided - relaxation the same symptoms, as at to a hernia. In connection with absence of hernial gate the infringement is impossible. The diagnosis is put on the basis of presence of symptoms of moving of belly bodies in a corresponding half of thorax, a lung, by displacement of bodies . Radiological research is the basic method confirming the diagnosis. At imposing diagnostic over the - bodies moved to a thorax define a diaphragm shade. The limited right-hand relaxation differentiate with - tumours and a lung, a pericardium, a liver. Treatment: in the presence of the expressed clinical symptoms surgical treatment is shown. Operation consists in bringing down - of the moved belly bodies in normal position and formation diaphragms or - its plastic - strengthening by a grid from , a - skin, muscular or myshechno-nadkostnichno-pleural rag . STOMACH Stomach borders. External top border of a stomach are. In front a shoot, edges of costal arches, behind edge of XII edges, XII chest vertebra.

After Passage - Waves Again It Is Closed.

After passage - waves again it is closed. At there is no reflex relaxation at swallowing, and pressure remains on former figures. Other characteristic sign is infringement - a gullet: The various form and vneglota-telnye reductions, a considerable quantity local - secondary reductions of a gullet that testifies about . At all patients along with spastic reductions - mark a considerable quantity gullet reductions. In doubtful cases for diagnosis acknowledgement use pharmacological tests. Nitroglycerine, at patients with reduce a tone - of a gullet and physiological that facilitates passage of a contained gullet to a stomach. Introduction medical products (, , ) has stimulating an effect on a muscular layer walls and on . At a cancer and organic stenoses of a gullet both tests - happen negative. The differential diagnosis: great difficulties meet at carrying out of the differential diagnosis between and a cancer of a gullet and . It is necessary to consider age of patients: younger at and elderly at a cancer.

At Gullet Punching Mark Contrast Substance For Its

At gullet punching mark contrast substance for its contours, presence emphysemas, at development of fistulas - contrast hit in a tree. The big diagnostic value has , specifying character of a foreign matter and its arrangement. Treatment: at suspicion on a foreign matter of a gullet of the patient it is necessary to direct to a surgical - hospital at any time-. Removal of foreign matters of a gullet make under a narcosis with application by means of rigid and a set special . At impossibility to remove a foreign matter through operation which consists in , foreign matter removal, gullet walls is shown. Even at long asymptomatic stay of a foreign matter in a gullet patients should recommend persistently its removal, because of possibility of development of heavy complications. CHEMICAL BURNS AND CICATRICIAL NARROWINGS OF THE GULLET Chemical burns of a gullet. The damages of a gullet caused - by reception of acids (more often acetic acid) or alkalis (more often liquid ammonia, soda), are called as toxic .

At It Is Possible To Find Out "serpentine"

At it is possible to find out "serpentine" expansion of veins seed -. The expanded veins are easily fallen down at pressing on them or at a raising up. Attention! can arise at a tumour of the bottom pole of a kidney veins. That is why patients with should investigate kidneys. Treatment: the surgical. An operation overall objective apropos hernias - a plasticity the channel. Operation spend on stages. The first stage - access to to the channel, in areas a slanting cut in parallel to a sheaf and above from it on 2 sm, from bones to . A section an external slanting muscle of a stomach on a course of fibres. The top rag separate from internal slanting and cross-section muscles. The bottom rag separate from - seed , baring thus a trench sheaves to - . The second stage - allocation and removal of a hernial bag. The - third stage - deep rings till the normal sizes (in diameter 0,6 - 0,8 sm). If deep the ring is not taken in, there are anatomic preconditions for occurrence of relapse of a hernia! At slanting to a hernia deep the ring - is always expanded.

The Endoskopicheekaja Picture Depends On Duration Of Disease.

The endoskopicheekaja picture depends on duration of disease. In an onset of the illness the - gullet is expanded slightly, in process of disease progressing its gleam more and more extends and at some patients - becomes . The mucous membrane has - inflammation signs-: folds , arteries and veins are expanded, quite often visible sites , erosion, , . As a rule, the end manages to be spent through the narrowed site that confirms mainly functional - character of changes in a gullet. The mucous membrane in a narrowing place is not changed more often. Ezofagotonokimografichesky research - the main method of early diagnostics a gullet as infringements - abilities of a gullet and physiological arise considerably before clinical symptoms of disease-. Research spend by means of a special multichannel - probe with rubber or "opened" -, registering reductions of a gullet and change in-pishchevodnogo pressure. In norm after swallowing on a gullet the - wave extends , during this moment - pressure opens also decreases.

Pathological Anatomy: Ulcers Are Localised In Belly Department

Pathological anatomy: ulcers are localised in belly department of a gullet directly over or a - little above. They usually single, but can be and - plural, having the same stage of development. Their diameter does not exceed 0,5 - 1 sm, but there are ulcers of the big sizes. The form of ulcers more often roundish or slightly oval. The mucous membrane - round an ulcer is inflamed, ulcer edge , the bottom is covered by serovato-yellow touch which easily acts in film. The - gullet gleam - at ulcer level is narrowed owing to an inflammatory hypostasis - of a mucous membrane and cicatricial deformation. Ulcer healing - is accompanied by even more considerable narrowing of a gleam of a gullet. In ulcer edges can occur (Barret's ulcer), at some patients is marked - simultaneous longitudinal a gullet (Barret's syndrome) At 8 - 10 % of these patients against an ulcer develop a cancer. Clinic and diagnostics: the most frequent symptom - a pain behind a breast or in areas, can in a back, in heart area.

The Small Branch Which Goes To The Left

The small branch which goes to the left behind a gullet to a stomach in the field of coal of Gisa ("a criminal" nerve of Grassi) sometimes can depart from the right trunk of a wandering nerve. It matters in an aetiology - of recurrent ulcers after if remained not crossed. Beginning from level , the thin branches going along small blood vessels to small curvature of a stomach depart from the main trunks. Each trunk of a wandering nerve comes to an end according to a forward and back branch of Latarzhe. Functional - anatomy of a mucous membrane - of a stomach. In all departments of a stomach a mucous membrane surface tsilindricheski-. cages. They allocate "visible - slime" - a viscous liquid consistences. This liquid in the form of a film densely covers all surface - of a mucous membrane. Slime facilitates food passage, protects a - mucous membrane from mechanical and chemical damages. A slime film, superficial - are the protective barriers - protecting a mucous membrane from self-digestion by gastric juice.