In Development Hernias Result Weakness Fabrics-, Age ,

In development hernias result weakness fabrics-, age , adiposity, pregnancy, the factors promoting increase of intrabelly pressure. At - sliding hernias diaphragm apertures often insufficiency , leading zheludochno-pishchevodnomu to a reflux (the section "Insufficiency " see). Clinic and diagnostics: at sliding hernias - apertures of a diaphragm symptoms are caused a reflux-ezofagitom. Patients complain on burning or dull aches behind a - breast, at level a shoot, in areas, in , in heart area, a shovel, the left shoulder quite often sick therapists concerning a stenocardia observe-. The pain amplifies in horizontal position of the patient and at physical activity, at trunk inclinations forward (a symptom, " a boot"), i.e. When occurs zheludochno-pishchevodnyj a reflux is easier. The pain is accompanied by an eructation, , a heartburn. In due course at patients appears which to a thicket has alternating character and becomes a constant at development a gullet. The frequent symptom - a bleeding which usually happens hidden, is seldom shown by vomiting by blood of scarlet colour or colour of a coffee thick, degteobraz th chair.

Some Patients It Is Artificial Cause Vomiting For

Some patients it is artificial cause vomiting for sensation removal behind a breast and the pains appearing during meal. The fetid odour from a mouth is marked in connection with decomposition of the food which has late over a tumour or disintegration of the tumour. The nausea and eructation are observed at patients at by a tumour of walls - of a gullet in the field of physiological . Strengthened , at a gullet cancer, as well as at stenoses of other aetiology, results from reflex excitation - of salivary glands at irritation of receptors of a gullet and wandering nerves. Plentiful bleedings from a gullet in connection with tumour disintegration happen seldom. The general displays of disease (the weakness, a progressing weight loss (at 51 %), an anaemia) are a consequence of starvation and - intoxications. Symptoms of a cancer of the gullet, arising owing to - process distribution - on the next bodies and fabrics, carry to late displays of illness, usually they testify about neoperabel-nosti tumours.

The First Symptoms Of Illness Are More Often

The first symptoms of illness are more often shown, at the age of 20 40 years. Women is more often are ill. Aetiology and : factors - congenital anomalies of development of the nervous device of a gullet (a degeneration intermuscular textures); a neurasthenia with occurrence a gullet motility; reflex dysfunctions of a gullet; infectious-toxic defeats of nervous textures and . The resolving factor is the stress or a long emotional pressure. : at research pressure in the field of pishchevodno-gastric transition it is found out (physiological ). At healthy people it in rest is in a condition of tonic reduction, and after swallowing relaxes-. The main infringement defining symptoms of disease, absence of a relaxation or an insufficient relaxation after swallowing is. Various reactions (incomplete disclosing at swallowing, incomplete disclosing and a spasm, full aha-lazija, and a spasm, an initial hypertone, etc.) Have one initial mechanism infringement walls. Cases , proceeding with a hypertone -, cannot be considered as true "" as the basic mechanism breaking passableness , the hypertone , and absence of its relaxation is not at swallowing.

Persistent Pains In The Left Half Of Thorax

Persistent pains in the left half of thorax can be connected with tumour germination in a pleura. At defeat physiological - at patients the nausea - and an eructation is marked-. Tumour germination in a nerve causes a hiccups. In late stages arise and vomiting. The basic method of diagnostics of a cancer of a gullet is radiological research which begin with survey - a chest and belly cavity where against back - in slanting positions against a - gas bubble of a stomach at a number of patients the tumour shade is possible to see. Survey and a chest cavity allow to reveal metastasises in lungs and . After that investigate a - gullet by means of a water suspension of sulphate of barium. In an initial stage - of a cancer define on from walls - of a gullet defect of filling, deformation and roughness of contours of a mucous membrane. In the field of a tumour arrangement is available gullet walls. At - circular growth of a tumour there comes narrowing of a gleam of a gullet which - looks like and the rough channel.

Treatment, Antibiotics, Heat, At Occurrence Of Signs Of

Treatment, antibiotics, heat, at occurrence of signs of a suppuration is shown abscess opening. Extremely seldom meet specific inflammatory about in a belly wall (, a tuberculosis, a syphilis). Tumours of a belly wall happen good-quality and - malignant. In areas often meet so-called - which give rise to hernias - of a white line of a stomach. Fibromas, , rabdomio and a belly wall to distinguish a tumour - which is starting with fabrics of a belly wall, from a tumour located in a belly cavity are described-, it is necessary to spend a stomach during - pressure of muscles of a belly wall For this purpose to the patient - suggest to rise from horizontal position, leaning against the hands bent in elbows. At pressure of muscles of a belly wall the tumour located , is not palpated, and the - tumour of a belly wall is defined more distinctly. formation in the field of a navel the endometriosis This tumour can be original meets only at - women, for it the sharp increase in sizes and in connection with a cycle and pregnancy is characteristic-.

At <4,5 In A Gut Cavity Liberated Brakes

At <4,5 in a gut cavity liberated brakes secretion of hydrochloric acid, stimulates - allocation of bicarbonates and water with a pancreas, a liver, glands of Brunnera. At neutralisation of hydrochloric acid by an alkaline secret in a cavity of a duodenal - gut value raises, liberation stops and secretion of gastric acid renews. Powerful secretions of hydrochloric acid is . It is developed , cages, concerns family . Brake action on secretion of hydrochloric acid renders gastric brake ( - ). - Increase of concentration in blood is observed after reception fat write also carbohydrates. As a result actions stimulating and braking - secretion of hydrochloric acid of mechanisms production of hydrochloric acid is carried out by cages in the limits necessary for digestion and maintenance - of a kislotno-alkaline condition in physiological limits. Motor function Out of a phase of digestion a stomach is in the - slept condition. During the meal certificate thanks to change of a tone of muscles ("- ") the gastric tank can contain about 1500 ml without appreciable increase pressure.

A Cancer Of The Bottom Third Of Gullet

A cancer of the bottom third of gullet in the lymph nodes located round a gullet and , lymph nodes, on a course an artery and its branches in a liver. At tumour localisation in department of a gullet metastasises extend in , - radical and lymph nodes. However at a - cancer department of a gullet the tumour can in the lymph nodes located below a diaphragm in area , on a course an artery and its branches. That is why some surgeons recommend operation at a gullet cancer always - to begin with and audits of bodies of a belly cavity and spaces. At a gullet cancer observe metastasises on and to a pleura. The remote metastasises meet - in a liver more often-, is more rare - in lungs, bones and other bodies. Gematogennoe distribution occurs in a late stage of disease. at the overwhelming majority of patients the - gullet cancer - happens . Meet (at 8 - 10 %) which develop from ektopiro-bathroom islets in a gullet of a mucous membrane of a stomach or from glands which are available in the bottom department of a gullet Less often.

Diaphragm Blood Supply Carry Out Top And Bottom

Diaphragm blood supply carry out top and bottom the arteries departing from an aorta, myshechno-diafragmalnaja and perikardo-diafragmalnaja the arteries departing from internal chest, and also six bottom intercostal arteries. Blue blood outflow occurs on the veins with the same name, on unpaired and - semiunpaired veins, and also on gullet veins. Lymphatic vessels of a diaphragm form some networks: , pleural, intrapleural, , . On the lymphatic - vessels located along a gullet, an aorta, the bottom hollow vein and other vessels and the nerves passing through a diaphragm, inflammatory process can extend from a belly cavity in pleural and on the contrary. - Lymphatic vessels take away a lymph from above through and back knots, from below - through and . diaphragms carry out and intercostal nerves. Allocate static and dynamic functions of a diaphragm. Statistical function of a diaphragm consists in maintenance of a difference of pressure in chest both belly cavities and normal mutual relations between their bodies.

Further Comes - Tumours And Development Inflammations. Supras-Tenotichesky

Further comes - tumours and development inflammations. Supras-Tenotichesky expansion of a gullet at a cancer seldom happens - considerable as the tumour develops in rather short period of time. Distribution of a cancer of a gullet occurs by direct - germination, and . The tumour can extend on a gullet upwards and downwards, to sprout all layers of its wall, to squeeze the next bodies. Rather late complication is tumour germination in the next bodies which can lead to fistula formation between a gullet and a trachea or a bronchial tube, to development of a pneumonia, a gangrene and processes in lungs and a pleura, to a deadly - bleeding at tumour germination in an aorta. cancer cages on lymphatic vessels in a gullet wall can occur on 10 - 15 sm from visible - border of a tumour. Such "cancer " meets at process localisation in the top and average third of gullet is more often. Along with distribution of a tumour to process - superficial and deep lymph nodes are involved-. The tumours - located in cervical and departments of a gullet, mainly in , over - and lymph nodes.

Diagnostics Hernias At Women Is Based On Survey

Diagnostics hernias at women is based on survey and as finger introduction in an external aperture - the channel is impossible. At women a hernia differentiate with a round sheaf of the uterus which is passing in the channel. a round sheaf of a uterus unlike a hernia does not change the sizes at horizontal position of the patient, - a sound over it always stupid, and over a hernia can be . Treatment a round sheaf of a uterus, as well as hernias, surgical. Operation consists at a distance with a subsequent plasticity the channel. Differential diagnostics between hernias and a femoral hernia is resulted at the description of a femoral hernia. Table 4: Differentsialno-diagnostic signs a plait and a straight line hernias of PriznakiKosaja a hernia Forms and an arrangement hernial Back wall the channel Direction a push The relation of a hernial bag to seed to a congenital Thicket happens in children's and middle age of the Oblong form at plumpness on a course the channel Often the - unilateral falls in - to the Thicket It is expressed in an initial stage of formation of a hernia The kashlevoj push in an initial stage of formation of a hernia is felt sideways from outside a deep aperture the channel The thickening seed on the party happens at elderly and old people The roundish form a swelling at a medial part sheaves Seldom falls in to the Thicket bilateral (especially at elderly patients) It is always weakened The kashlevoj push is felt directly against an external aperture the channel The hernial bag is located from seed pahovo-moshonochnaja a hernia, the increase in the sizes , gets similarity to a dropsy of covers .

Pressure Increase In Physiological Thus Is Secondary And

Pressure increase in physiological thus is secondary and is caused by its reaction to - constant pressure of contents filling a gullet, rubtsovo-inflammatory changes in fabrics of terminal department - of a gullet and loss of elasticity by them. At simultaneously change a tone and - a gullet. Instead of extending to a stomach - reductions appear (- not providing a passage) waves, join them segmentary reductions of a wall of a gullet. The food long is late in a - gullet and arrives in a stomach owing to mechanical disclosing under the influence of hydrostatic pressure of a column of a liquid over it. Long stagnation of food weights, a saliva and slime in a - gullet leads to considerable expansion of its gleam, development and that in turn aggravates infringements - a gullet. Pathological anatomy: in the expressed cases of disease mark gullet expansion in diameter to 15 - 18 sm, its lengthening owing to what it can accept the S-shaped form. Its capacity reaches 2 - 3 l instead of 50 - 100 ml at healthy people.

Treatment: Principles Of Surgical Treatment At A Sarcoma

Treatment: principles of surgical treatment at a sarcoma same, as well as at a gullet cancer. Some kinds of sarcomas well - give in to beam therapy. In the started cases of disease - spend symptomatic therapy. DIAPHRAGM Diaphragm - the suhozhilno-muscular formation dividing chest and belly cavities. The muscular part of a diaphragm begins on a circle - of the bottom aperture of a thorax from a breast, an internal surface of cartilages VII - XII edges and lumbar vertebras (, costal and lumbar departments of a diaphragm). Muscular bunches go up and radially and - dome-shaped cambers come to an end - with the centre, forming on the right and at the left. Between and costal department is available space (a triangle - of Morgani, Larreja), filled . Lumbar and costal departments are divided by pojasnichno-costal space (a triangle of Bohdaleka). The lumbar - department of a diaphragm consists from each party of three legs: external (-), intermediate and internal (medial). Suhozhilnye edges of both internal (medial) legs of a diaphragm form at level of I lumbar vertebra more to the left from a median line an arch limiting an aperture for an aorta and a chest lymphatic channel.

At A Stomach Specify An Arrangement In Relation

At a stomach specify an arrangement in relation to a diaphragm, study a condition - of the part of a stomach moved to a - thorax and its mutual relation with a gullet and . it is shown at suspicion on an ulcer a polyp or on a stomach cancer. Treatment: at not complicated sliding hernias - diaphragm apertures spend conservative treatment - which is directed on decrease zheludochno-pishchevodnogo a reflux reduction of the phenomena , the prevention of increase of intrabelly pressure. The patient recommend to sleep with the raised headboard of a bed, to avoid the positions of a body facilitating - occurrence of a reflux, to watch regular function of intestines a Food should be in the small portions 5 - 6 times a day last food intake for 3 - 4 to a dream. Depending on expressiveness appoint mechanically and chemically sparing diet (a table 1, 16, 1 on Pevzneru). The food should contain a - considerable quantity of fibers. Appoint , enveloping-, astringents, preparations, , , , sedative means and vitamins Surgical treatment at a sliding hernia diaphragm apertures is shown at a bleeding, development a gullet, and also at unsuccessfulness of long conservative therapy at patients with the expressed symptoms a reflux-ezofagita (see has undressed "Gullet").

Superficial - Quickly (1 - 2 ), Deep

Superficial - quickly (1 - 2 ), deep heal with formation of granulations and a connecting fabric. Healing occurs slowly, a connecting fabric and - hem formation probably during 2 - 6 months Are the period chronic - . Cicatricial narrowings of a gullet - are formed more often in several places, in process is quite often involved surrounding . Unions and - gullet deformation develop-. Rubtsovo-ulcer process in a gullet after chemical burns can last for years. As a result of it at separate patients cicatricial narrowings of a gullet arise even after the lapse of 10 - 20 years from the moment of a burn. Thus, at a burn it is possible to distinguish four stages of pathoanatomical changes conditionally: I stage - and a mucous membrane hypostasis, II stage - and , III stage - formation of granulations, IV stage - scarring. At chemical burns of a gullet the substance accepted inside renders, besides local, and action on an - organism from which first of all suffer heart, a liver, kidneys. Heavy nephritic insufficiency can develop.

Closing Of Hernial Gate Make By Sewing Together

Closing of hernial gate make by sewing together by an internal plait, cross-section muscles, an upper edge cross-section with and sheaves. It is necessary to pay attention to width of an internal aperture - of the channel and if necessary it should be taken in till the normal size additional seams on cross-section . A round sheaf of a uterus (seed ) stack on muscles. A plasticity - of a forward wall the channel make by an external slanting muscle of a stomach. UMBILICAL HERNIAS Umbilical hernia name bodies of a belly - cavity through defect of a belly wall in the field of a navel. At - normal development the umbilical ring completely grows. To a skin it is direct umbilical and . - Disease of an umbilical hernia reaches the highest point twice - the first time in the early childhood, and the second time is elderly about 40 years. At women the umbilical hernia meets twice more often, than at men that is connected with a stretching of an umbilical ring during pregnancy-. Umbilical hernias at children arise in the first 6 after a - birth when the umbilical ring was not generated yet.