Spend Under Local Or General Anaesthesia. Conservative Treatment

spend under local or general anaesthesia. Conservative treatment of hernias spend at umbilical hernias At children. It consists in application of bandages with which interfere an internal. At adults apply a - various kind bandages. Bandage carrying appoint patient who cannot be operated because of presence at them serious contra-indications to operation ( - chronic diseases of heart, lungs, kidneys, a cirrhosis, -, , malignant new growths). The purpose of carrying - of a bandage - to interfere an internal in a hernial - bag. The bandage promotes closing of hernial gate. Bandage carrying probably only at hernias. - Long carrying of a bandage promotes an atrophy of fabrics of a belly wall, formation of unions between an internal and a hernial bag, i.e. Conducts to development hernias. Preventive maintenance: observance of hygiene of chest - children which consists in care of a navel, correct feeding, regulation of function of intestines matters-. Regular employment by physical culture and sports as means of strengthening of muscles and an - organism in general.

On And Functions Distinguish Three Ferruterous - Zones.

On and functions distinguish three ferruterous - zones. L Kardialnye of gland - allocate slime thanks to which sliding of a food - lump is provided-. 2. , or the main things, glands are constructed of four kinds of cages. The main cages allocate - . Parietalnye cages develop hydrochloric acid and the internal factor of Kestlja. Additional cages allocate the soluble slime possessing buffer properties. Not differentiated cages are initial for all other cages of a mucous membrane. 3. Antradnye glands allocate soluble slime with , close to an - extracellular liquid, and a hormone from G-cages. Accurately outlined border between and glands is not present. A zone where both kinds of glands are located, name transitive. The area of a transitive zone of a mucous membrane is especially sensitive to action of damaging factors, here mainly arise . With the years there is a - distribution glands in a direction, i.e. To , at the expense of an atrophy glands. In a mucous membrane of a duodenal gut between cages are located cages: G-cages develop , S-cages-sekretin, I-kdetki - - .

Dangerous Complication Is Perforation - Of A Gullet

Dangerous complication is perforation - of a gullet and development . Indications to operation at cicatricial a gullet: 1) a full obliteration of a gleam of a gullet; 2) numerous unsuccessful attempts of carrying out through ; 3) fast cicatricial after repeated ; 4) presence fistulas with a trachea or a bronchial tube; 5) expressed extended ; 6) repeated gullet punching at . At a heavy exhaustion for a food by the patient impose as the first stage of treatment. At a choice of a method of operation consider age and the general condition of the patient, localisation and extent of narrowing of a gullet. At the majority of patients make plastic operations. A mnogoetapnuju plasticity carry out at the weakened patients. At segmentary make any partial plastics of a gullet. At defeat of the bottom part of a gullet or apply: imposing roundabout to food-vodno-gastric , a resection of the amazed site and replacement by its tube formed of the big curvature of a stomach, a transplant from a thin or thick gut.

Stomach Vessels With Each Other And With Branches

Stomach vessels with each other and with branches top arteries, form the branched out network vessels. - Rich blood supply of a stomach complicates a spontaneous stop of a bleeding - from ulcers, even defeats only a mucous membrane (erosion) can cause plentiful bleedings. Veins correspond to an arrangement of arteries and Venous textures in a layer around system veins with system of the top hollow vein are veins At portal these can become a source of bleedings. Studying of areas of lymphatic outflow has practical value at performance of radical operations concerning a stomach cancer. pau a stomach it is carried out by nervous textures (, intermuscular, ), wandering nerves and sympathetic nerves. Wandering nerves forward and back trunks reach along a gullet a stomach. Above the forward (left) trunk gives a hepatic branch, and from a back (right) trunk departs a branch to to knot. The left - wandering nerve before passage through a diaphragm aperture can be divided into two or three trunks.

At A Number Of Patients With Depends On

At a number of patients with depends on food temperature: badly passes or there does not pass warm food, and cold passes, or on the contrary. Patients gradually adapt to facilitate passage of food to a stomach by means of a number of receptions (walking, gymnastic exercises, air and a saliva-, reception of a considerable quantity of warm water, etc.). Expressed at observe seldom. at small expansion of a gullet comes after several drinks of food, at considerably expanded - gullet happens more rare, but plentiful and it is caused by the strong spastic reductions of a gullet arising at it nepe. in a prone position and at a strong - inclination of a trunk it is caused by mechanical pressure of a contained - gullet on glotochno-pishchevodnyj and its stretching. Night it is connected with some decrease in a tone glo-was exactly-pishchevodnogo . Pains behind a breast at have various character. They can be connected with a spasm muscles and are eliminated by nitroglycerine reception, and atropine.

Often Simultaneously There Are Damages Of A Thorax,

Often simultaneously there are damages of a thorax, bones of a basin, bodies of a belly - cavity. At ruptures and wounds of a diaphragm owing to - negative intrachest pressure there comes moving to a - pleural cavity of a stomach, a thin or thick gut, an epiploon, a spleen, a liver part. Moving of bodies can arise as directly after a trauma, and after any - time interval. Open damages of a diaphragm happen at koloto-rezanyh and fire wounds. They - are in most cases combined with damage of bodies of a chest and belly cavity. The clinic and diagnostics, in the sharp period prevail - symptoms of an accompanying trauma ( a shock, cardiovascular and respiratory insufficiency, a bleeding, a peritonitis, , crises of bones). Have diagnostic - value symptoms a lung and displacement of bodies . There can be an infringement - of the bodies which have dropped out in a pleural - cavity. To suspect diaphragm wound it is possible at presence over a - thorax at , intestinal noise at , at development of symptoms of intestinal impassability, - occurrence haemo- or at stomach wounds.

- Surgical Intervention Make Through 2 - 3

- Surgical intervention make through 2 - 3 after the - termination of beam therapy. At tumours, in the presence of contra-indications to radical operation make palliative interventions for the purpose of restoration of passableness of a gullet, improvement of a food of the patient. To palliative operations carry: palliative resections-, tumours an artificial limb (endoproteziro-vanie), imposing . Beam treatment apply both at radical, and at palliative therapy of a cancer of a gullet. Optimum results are received at use of sources high - (gamma therapies, brake radiation and fast ), providing leading to a tumour of a gullet of a high dose - of radiation. At a cancer of the top third of gullet after - imposing the patient spend radical beam therapy in a total dose 60 - 70 Gr (6000 - 7000 it is glad) at a - daily dose 1,5 - 2 Gr (150 - 200 is glad). At a cancer of an average third of gullet the patient impose , and then spend palliative beam therapy in a dose 20 - 40 Gr (2000 - 4000 it is glad), - which overall objective - removal , pains and delay of progressing of tumoral process.

Outside The Gullet Is Surrounded Friable Connect-telnoj In

Outside the gullet is surrounded friable connect-telnoj in which pass lymphatic, blood vessels and nerves the cover has only gullet department. Gullet blood supply in cervical department is carried out from the bottom thyroid arteries, in chest department - for the account actually the arteries departing from an aorta, branches of bronchial and intercostal arteries. Blood supply gullet department occurs from an ascending branch of the left gastric artery and a branch bottom arteries. In chest department gullet blood supply has segmentary character, therefore its allocation on a considerable extent from surrounding fabrics during surgical interventions can lead walls. Outflow of a blue blood from gullet department goes from and venous textures in and further in a vein. From the top departments of a gullet the blue blood flows through the bottom thyroid, unpaired and semiunpaired veins in system of the top hollow vein. Thus, in the field of a gullet are available between system and top hollow veins.

At A Method Apply To Closing Of Defect

At a method apply to closing of defect of a belly wall wide hips, plates and laces from skin. At a method use grids from synthetic fabrics (lavsan, teflon, , etc.). Implanted between layers of the rubtsovo-changed fabrics the implant can be used as a skeleton which then is filled with a cicatricial fabric in the course of healing-. This method apply at repeated relapses of postoperative - hernias when there is an extensive trellised defect in a hem, and fabrics of a belly wall are not differentiated almost-. To close defect local fabrics it is not obviously possible-. Preventive maintenance: a choice of correct operational - access without considerable damages of muscular layers, and nerves; refusal of application resolving a - material; restriction of indications to and a belly cavity; level-by-level mending of a wound of a belly - wall; preventive application of antibiotics during the operation accompanied by opening of hollow bodies and possible -, an exception of excessive physical activity after operation.

The Big Epiploon Is Restrained Usually In Umbilical

The big epiploon is restrained usually in umbilical and big hernias. The infringement of a bladder arises at sliding and femoral hernias, is accompanied frequent painful , sometimes by a delay , reduction - in connection with reflex decrease in function of kidneys. False infringement of a hernia. At sharp diseases of bodies of a belly cavity (the acute appendicitis, a sharp cholecystitis, perforation of an ulcer of a duodenal gut or a stomach, intestinal impassability) , getting to a hernial bag of not restrained hernia, causes in it inflammation development. Hernial increases in sizes, becomes painful and strained. These signs correspond to signs of infringement of a hernia. The diagnosis: to make the correct diagnosis of sharp diseases of bodies of a belly cavity and to exclude infringement of a hernia - carefully collected anamnesis of these diseases and the carried objective investigation of the patient helps. First of all it is necessary to find out time of occurrence of a belly-ache and in the field of a hernia, the pain beginning (sudden, gradual).

- Radiological Research Is The Basic Method Of

- Radiological research is the basic method of diagnostics - of damages of a diaphragm. It begin with survey - and bodies of a chest and belly cavity, - then in need of remote terms spend research of a stomach, a thin and thick gut. At - damages of the right dome of a diaphragm liver position judge according to radiological, ultrasonic researches and scanning. Treatment: at ruptures and diaphragm wounds the urgent operation consisting in of defect by separate - seams from of a material after bringing down - of belly bodies is shown--. Depending on a prevalence of symptoms of accompanying damages of bodies of a belly or chest cavity operation begin with laparo - or . HERNIAS Diafragmalnaja hernia - moving of belly bodies to a chest cavity through defects or weak zones of a diaphragm. The true hernia is characterised by presence of hernial gate, a - hernial bag and hernial contents. In the absence of a hernial - bag a hernia name false. At a true hernia the hernial bag is formed , from above covered - by a pleura.

Elastichesky Infringement. The Complication Beginning Is Connected With

Elastichesky infringement. The complication beginning is connected with increase of intrabelly pressure (a physical activity, cough, and ) Suddenly arises a strong constant pain in the field of hernial , earlier hernias, hernial it is necessary to mean increase, sharp pressure and morbidity that the infringement can be the first display of the arisen hernia. The infringement of a gut is one of forms intestinal impassability. In these cases signs of intestinal impassability against a constant acute pain in a stomach, caused vessels and nerves the restrained gut join, there is a pain connected with strengthening , a delay of a chair and gases, vomiting is possible. At a stomach continuous intestinal noise are listened. At survey a stomach the stretched loops of intestines with - horizontal levels of a liquid and gas over them ("bowls of Klojbera") come to light-. The peritonitis Later develops. At infringement of a gut in a clinical current of complication it is possible to allocate three periods.

In I Sharp Stage Of Disease (5 -

In I sharp stage of disease (5 - 10 ) patients - test heavy sufferings. After reception of caustic alkali or acid there are severe pains in an oral cavity, a drink, behind a breast, in areas, plentiful salivation-, repeated vomiting, owing to a spasm of a gullet in the field of a burn and a mucous membrane hypostasis. Swallowing - is impossible. Patients are raised, frightened. Integuments pale, damp. Breath is speeded up, there is a tachycardia. Mark - various degree of the phenomenon of a shock: excitation or block, slackness, bad reaction to surrounding conditions, drowsiness, , a tachycardia, decrease in the arterial pressure, - deaf tones of heart, reduction of quantity of urine up to -. In some hours after a burn along with shock symptoms there are symptoms burn : rise in temperature - of a body to 39 �, block is replaced by excitation, sometimes there is a delirium, muscular twitchings. Breath frequent, superficial, a pulse rate to 120 - 130 in minute, arterial pressure is lowered owing to .

As A Mouth Is Called The Part Of

As a mouth is called the part of a hernial - bag which borders on a belly cavity. As a neck - of a hernial bag is called the narrow department of a hernial bag which are - in thickness of a belly wall - in hernial collars. A body of a hernial bag - its greatest part. Distalnyj department of a hernial bag name a bottom. The hernial bag can be , two - three- and sometimes . At increase in a hernia as a result of a trauma and an inflammation in a hernial bag solderings - and are formed - that can promote infringement of contents - of a hernia in one of cavities (chambers) of a hernial bag. The full partition of a hernial bag with isolation of one segment can lead to formation a hernial bag. Contents of a hernial bag - the internal which has left in a hernial bag. Any body of a belly cavity (except a - pancreas) can be contents of a hernial bag to the Thicket the hernial bag contains the most mobile bodies of a belly cavity: the big epiploon, a small intestine. Classification of external hernias.

To Liquid Revealing In A Belly Cavity Apply

To liquid revealing in a belly cavity apply a method . The doctor puts a palm On one party of a stomach, on an - opposite side the bent fingers of other hand makes an abrupt push which in the presence of a liquid is defined by a "listening" palm. In order to avoid the erroneous conclusion it is necessary to exclude push transfer on a belly wall. For this purpose the doctor asks the patient or staff nurse to put an edge a brush on an average line of a stomach. At such reception distinct transfer of a push proves liquid presence in a belly cavity. In localisation of pathological process the - zone morbidities (a sign of local irritation -) allows to be guided--. the semibent fingers or a brush edge on the right costal arch can cause morbidity - in right (a symptom of Ortnera-Grekova) at an - inflammation of a bilious bubble, bilious channels, a liver. a stomach make in various positions - of the patient. At research of the patient in horizontal position it is necessary to ask the patient for a relaxation of muscles of a belly wall to bend feet in knee joints and slightly to dissolve them in the parties.