As A Result Inflammations Arise Dense Unions Of

As a result inflammations arise dense unions of bodies with each other - and with a wall of a hernial bag. can be partial when the part of contents of a hernia can be set in a belly cavity, and other part to remain . At full hernia contents are not set in a belly cavity. Development is promoted by long - carrying of a bandage. there are umbilical, femoral and postoperative hernias is more often. Often enough hernias happen multichamber (umbilical, postoperative). Owing to - development of plural solderings and chambers in a hernial bag the hernia becomes complicated infringement of bodies in - one of chambers of a hernial bag or development of adhesive intestinal - impassability in a hernial bag is more often--. The hernia inflammation arises owing to a hernial - bag. It can occur from within at an acute inflammation a shoot or Mekkelja which are in a hernial bag, as a result of punching or tubercular ulcers of intestines in a cavity of a hernial bag, at a tuberculosis . At the inflammation of a hernia caused from outside of bodies of a belly cavity, the general condition of patients worsens, a body temperature high, a fever, vomiting, a delay of gases and a chair.

The Definitive Diagnosis Establish At Radiological Research. The

The definitive diagnosis establish at radiological research. The radiological picture depends on character and volume of the belly bodies which have moved to a thorax, from degree of filling of a gastroenteric path. At stomach loss the big horizontal level in the left half of the thorax is visible, rising at reception of a liquid and write. At loss of loops of a small intestine against a pulmonary field - define separate sites of an enlightenment and blackout. Moving - of a spleen or a liver gives blackout in corresponding - a pulmonary field. At some patients the dome - of a diaphragm and the belly bodies located above it are well visible-. At contrast research of a gastroenteric path define character of the dropped out bodies (hollow or -), specify localisation and the sizes of hernial gate on the basis of a picture the dropped out bodies at aperture level - in a diaphragm (a symptom of hernial gate). At some patients for diagnosis specification impose diagnostic . At a false hernia air can pass in a pleural cavity ( define a picture ).

Unlike A Hernia At An Abscess It Is

Unlike a hernia at an abscess it is possible to receive a - fluctuation symptom-, to reveal at backbone research painful points at pressing on awned shoots of vertebras, and at loading on a backbone axis - morbidity in the field of lumbar - department of a backbone. - It is necessary to make for acknowledgement of the diagnosis of a tuberculosis - of a backbone a backbone. Treatment: the surgical. Way Bassini - a cut do in parallel to a sheaf and below it over hernial . After high allocation - of a hernial bag it open, stitch as it is possible above and cut. Close hernial gate by sewing together - and sheaves. Impose 2 - 4 seams. The second row of seams between crescent edge wide hips and edge take in the femoral channel. Operation of a femoral hernia by way (on a method of Rudzhi) - do a cut as at to a hernia. Open - an external slanting muscle of a stomach. Bare an - interval. Dissect cross-section in a longitudinal direction. Removing , allocate a neck of a hernial bag. A hernial bag deduce from the femoral channel, open-, stitch and delete.

). Expansions Of A Gullet Do Not Observe. At

). Expansions of a gullet do not observe. At some patients a gullet are shown by these volumes similar to symptoms (, -, pains). However radiological research allows to make the correct diagnosis. Treatment: conservative therapy at apply only in initial stages of disease, and also use as addition to and by preparation of patients for surgical treatment. The food should be and thermally sparing, rich fibers, vitamins. A food fractional, last food intake for 3 - 4 to a dream. Reduction in I - II stages of disease can achieve by - application of preparations of nitrogroup - nitroglycerine, At the phenomena stagnant apply - gullet washing - by a weak solution of antiseptic tanks Therapeutic effect mark after physiotherapeutic procedures with , deep on area , long-wave , etc. The basic method of treatment - which consists in a violent stretching and a partial anguish of muscles a site of a gullet and . it is possible to spend in any stage - of disease by Contra-indication to its use are, a - portal hypertensia with expansion of veins of the gullet, expressed , the diseases of the blood accompanied - raised the Greatest distribution to the USSR now has received pneumatic - which consists from a rubber tube-probe on which end the cylinder Diameter of a cylinder from 25 to 45 mm Pressure in system is strengthened forms create a pear and supervise a manometre In an initiation of treatment apply dilators - of the smaller size and create in them pressure 180 - 200 mm , apply subsequently cylinders diameter and gradually increase in them pressure to 300 - 320 mm Duration - of procedure of a stretching 30 - 60 with, Interval between sessions 2 - 4 days Usually during a stretching patients a moderate pain behind a breast and in areas After procedure by the patient appoint a confinement to bed and hunger on 2-3 before pain disappearance.

At A Bleeding, For Definition - Of Deficiency

At a bleeding, for definition - of deficiency of volume , circulating in a vascular channel, it is possible to be guided by a shock index: Shock index = the Pulse rate / the HELL In norm this indicator makes 0,5. Losses of volume - of a circulating liquid to 30 % raise a shock index to 1, thus indicators of a pulse rate and arterial pressure nearby 100. At the expressed picture of a shock c 120 in a minute and arterial pressure about 80 mm hg, the indicator of a shock index raises to 1,5 and testifies to the beginning of danger to a life of the patient. The shock index equal 2 (pulse 140 in a minute, arterial pressure of 70 mm the item), corresponds to reduction of volume of a circulating liquid by 70 %. At women at gathering of the gynecologic anamnesis it is necessary to pay attention to the transferred gynecologic diseases, - a cycle, time of the last . The reason of occurrence of a belly-ache of century for the middle a cycle can be - . At a delay there is a basis - to suspect extra-uterine pregnancy.

Ultrasonic Research Of A Bilious Bubble, Pancreas, Liver,

Ultrasonic research of a bilious bubble, pancreas, liver, spleen for revealing of an inflammation or damage - of bodies. Laparoscopy for revealing of an inflammation or body damage. Diagnostic peritoneal th make at suspicion on punching of hollow body-, a bleeding, not revealed by other - methods. Into a belly cavity enter through a small cut of a belly wall on an average line of a stomach and make washing - of a belly cavity by an isotonic solution of chloride of sodium. In a washing liquid the blood impurity testifies to inside-brjushinnom bleeding, and gastroenteric contents - about punching of hollow body. The differential diagnosis: the - diseases simulating a sharp stomach, a myocardium heart attack, , spontaneous , nephritic , Shenlejna - Genoha should be excluded-. Preoperative preparation. Antishock actions (correction of infringements vodno-elektrolitnogo balance and a kislotno-alkaline condition, at a bleeding completion ). Introduction of antibiotics at the confirmed diagnosis of an inflammation, punching of body, intestinal impassability.

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.