Hernias Allocate Diaphragm Apertures In Separate - Group

Hernias allocate diaphragm apertures in separate - group as they arise most often, have features - of an anatomic structure, clinical displays and demand certain principles of treatment (the section "Hernias diaphragm apertures" see). Describe separate cases of rare hernias of other natural apertures of a diaphragm (a crack of a sympathetic nerve, an aperture - of the bottom hollow vein). Clinic and diagnostics: occurrence and degree - of expressiveness of symptoms hernias depend on character of the moved belly bodies in a pleural cavity, their volume-, degree of filling of the moved hollow bodies, and their excess in the field of hernial gate, degree of a collapse of a lung and displacement , the sizes and the form of hernial gate. Symptoms: gastroenteric, legochno-warm and the general. The factors leading to increase of intrabelly pressure, strengthen expressiveness of symptoms of disease in connection with - increase in a contained hernial bag. Patients complain of feeling of weight and a pain in areas, a thorax, , a short wind and the palpitation arising after plentiful food intake.

Treatment - Surgical - Good-quality Tumours Of A

Treatment - surgical - good-quality tumours of a belly wall also make level-by-level mending of a wound Malignant tumours of a belly wall mostly happen secondary (metastasises of a cancer of a stomach in navel area, metastasises , etc.) STOMACH HERNIAS Hernia (hernia) name interiors through natural or pathological apertures from a cavity - normally occupied with them, under covers of a body or in other cavity. Distinguish external and internal hernias of a stomach External hernias of a stomach is an internal together with from a belly cavity through artificial apertures of a belly wall hypodermic at preservation of integuments. Internal hernias of a stomach are formed in a cavity at penetration of interiors into pockets . Unlike an external hernia of a stomach at - occurs an internal without through the damaged belly wall under a skin (a hypodermic event-portable radio set) or outside (external ). Loss of interiors - name body outside through a natural aperture (for example, loss of a rectum, a uterus).

The External (superficial) Aperture The Channel Is Formed

The external (superficial) aperture the channel is formed by legs an external slanting muscle of the stomach, one of them is attached to - , another - to to an union Size of an external aperture the channel is various In cross-section it happens 1,2 - 3 sm, in - longitudinal - 2,3-3 the external aperture the channel slightly less, than at men see At women. Internal slanting and cross-section muscles of a stomach in . Areas are difficultly separable from each other. This muscular layer, settling down in a fillet - sheaves, approaches to seed and it is thrown through it, forming the different form and size the Border interval an interval: from below - a sheaf, from above - edge of internal slanting and - cross-section muscles of a stomach, from the medial party - external edge of a direct muscle of a stomach. The pahovyj interval can have , or the triangular form. The triangular form an interval testifies to weakness areas Cross-section in areas in two places it is strengthened by fibres on lateral edge of a direct muscle of a stomach goes ligamentum Henle.

Sliding Hernias Of A Thick Gut Happen At

Sliding hernias of a thick gut happen at slanting hernias, and a bladder at straight lines hernias is more often. Sliding hernias make 1 - 1,5 % of all hernias. Sliding hernias on the occurrence mechanism can be congenital and got. At congenital sliding hernias bodies (for example, the thick gut, a bladder) under the influence of the various reasons, sometimes since the period, gradually can some departments which have been not covered - to go down or as though to slide off on friable to internal hernial collars, to leave a belly cavity and to become a component hernial without a hernial bag. The got sliding hernias arise owing to - mechanical tightening adjacent to it of segments of a gut or a bladder, deprived of a serous cover. The sliding hernia of a thick gut has no symptoms. Usually it is the big hernia with wide hernial collars at persons of elderly or senile age. Diagnostics is helped by radiological research of a thick gut . At sliding hernias of a bladder of patients can - disturb frustration or in two ' | reception.

In A Medial Corner Of A Wound File

In a medial corner of a wound file - edge vaginas of a direct muscle of a stomach to - bones in area . Seed - stack on the formed muscular wall. Thanks to imposing of deep seams there is a restoration weakened - back the channel and narrowing - of its internal - aperture till the normal size. Edges an external slanting muscle of a stomach sew over seed edge in edge. Thus reconstruct a forward wall the channel and external a ring In some cases, especially at high a triangle, after sewing together of internal slanting and cross-section muscles with - a sheaf there is a considerable tension of seams that - promotes their procutting and hernia relapse In such cases - it is expedient to spend a cut of a vagina of a direct muscle of a stomach (operation the Poppy-blowing - Venglovsky). Way Kukudzhanova. It is offered for direct and difficult forms hernias After deep rings - impose seams between a vagina of a direct muscle of a stomach and - Cooper's sheaf-, from to a case - vessels In case of an outlined tension before setting - of seams in medial department of a vagina of a direct muscle do - slanting a cut in length 2 - 2,5 sm Then the connected - sinew of internal slanting and cross-section muscles together with top and bottom edges cross-section - file to to a sheaf the Latest seam impose at medial edge of a deep aperture the channel.

Low Arrangement Of A Diaphragm Mark At An

Low arrangement of a diaphragm mark at an emphysema easy, big hernias of a forward belly wall, , constitutions. Paradoxical movement of a diaphragm (lifting at a breath and lowering at an exhalation) happens at paralyses and its relaxation. For studying of character of movements of a diaphragm and its - functional condition use special radiological methods of research: , a tomography. Position and a diaphragm condition judge at contrast radiological research of a gullet, a stomach, intestines, at imposing artificial , and . Change of position and diaphragm function is accompanied by reduction of respiratory volume of lungs, changes . DIAPHRAGM DAMAGES The closed damages of a diaphragm arise at road - traumas, falling from height, an air contusion, a stomach. Diaphragm rupture in these cases is caused by sudden increase of intrabelly pressure. Damages - settle down in area the centre or in a place of its transition in a muscular part of a diaphragm is more often-. In 90 - 95 % of cases occur rupture of the left dome of a diaphragm.

In A Hernial Bag Of Bodies Occurs Outside.

In a hernial bag of bodies occurs outside. The kalovoe infringement arises at easing intestines, is more often observed at people of advanced age. Following-tvie congestions of a considerable quantity intestinal contained in a gut which is in a hernial bag, occurs a - departing loop of this gut, then pressure of hernial gate upon contents of a hernia amplifies and to joins , thus there is a mixed form of infringement. Pathological anatomy: a development principal cause changes in the restrained body is infringement krovo - and . At infringement of a gut owing to venous occurs in a gut wall, in its gleam and in a cavity of a hernial bag. A liquid in a hernial bag name "hernial water". At fast simultaneous a restraining ring of veins and arteries a gut which are in a hernial bag, "hernial water" is not formed, develops "a dry gangrene" restrained gut. In the beginning of infringement the gut gets colouring, "hernial water" the transparent. Nekrotichesky changes in a gut wall begin with a mucous membrane.

Stomach Survey. In Vertical Position Of The Patient

Stomach survey. In vertical position of the patient a normal - configuration of a stomach characterises moderated areas and some the bottom half of stomach. On a back at not corpulent patient level of a forward wall of a stomach is in a prone position below breast level. Uniform - a stomach observe at adiposity, intestines-, a liquid congestion in a belly cavity . Non-uniform - a belly wall can be at - stomach hernias-, at impassability of intestines, at , abscesses - of a belly wall and localised in a belly cavity, at the tumours which are starting with a belly wall and bodies of a belly - cavity. Change of a configuration of a belly wall observe at excessive strengthening a stomach and an intestines. Gathered in the - stomach happens at the exhausted patients, at sharp pressure of muscles of a belly wall (a symptom of muscular protection - a reflex at irritation ). In the presence of - postoperative hems their localisation, the sizes, defects in a belly wall in the field of hems (- postoperative hernias) should be noted-.

Congenital (insufficiency) - A Consequence - The Nervously-muscular

Congenital (insufficiency) - a consequence - the nervously-muscular device physiological or straightening of a corner of Gisa. The clinical picture is similar to displays of a congenital short gullet. Congenital short gullet. At this developmental anomaly the stomach part appears located above a diaphragm. The - clinical picture is caused by insufficiency , - accompanied zheludochno-pishchevodnym a reflux. After feeding at children arise , vomiting sometimes with an impurity of blood as a result of development . Complications of developmental anomalies of a gullet. The most frequent - complication at congenital , stenoses, pishchevodno-respiratory fistulas is the pneumonia. a gullet can lead to starvation of the child, at stenoses develops - stagnant . bronchial tubes the increasing doubled gullet causes a repeated pneumonia, development , the suppuration and break in respiratory ways or a pleural cavity is possible. from a stomach mucous membrane can be exposed with bleeding and punching development.

The Interval Of Lesgafta - Grjunfelda Is Between

The interval of Lesgafta - Grjunfelda is between an internal slanting muscle of a stomach - in front and from below, longitudinal muscles of a backbone and a square muscle from the - middle, the bottom gear muscle and XII edge from above. The interval looks like a - quadrangle. A bottom of this interval is a cross-section muscle - of a stomach. Through these intervals there can be lumbar hernias. On an aetiology they happen congenital, got (traumatic and spontaneous). Diagnostics of these hernias is not difficult. Treatment: the surgical. Zapiratelnye hernias leave through defects membranes apertures. Meet at women in advanced age is more often. It it is possible to explain in the big size apertures and more expressed - inclination of a basin at women. Hernial settles down on a lobby -. However happen hernias when visible approximately is not present. Such hernias are distinguished only at infringement - during operation. Treatment: the surgical. Promezhnostnye hernias (forward and back).

Lymphatic Vessels Cross, Their Central Ends , And

Lymphatic vessels cross, their central ends , and peripheral with veins on type the end sideways or the end in the end. Thus carry out to 6 - 10 . The operations executed in initial stages chronic , completely normalise from the amazed - finiteness, in later stages allow to achieve considerable reduction of a hypostasis of a skin and hypodermic -. GULLET The gullet represents a muscular tube in length about 25 sm, inside a mucous membrane and surrounded with a connecting fabric. It connects to a drink with a stomach part. The gullet begins at level of VI cervical vertebra and is stretched to level of XI chest vertebra. The input in a gullet is located at level a cartilage and will defend from a first line of the top cutters on 14 - 16 sm ("a gullet mouth"). In this place there is a first physiological narrowing. a gullet divide into three departments: cervical (5-6 sm), chest (16 - 18 sm) and - (1-4 sm). The second physiological narrowing of a gullet is approximately in 25 sm from edge of the top cutters at level tracheas and crossings of a gullet with the left main bronchial tube, the third corresponds - to level apertures of a diaphragm and is located on distance 37-40 see In a cervical part and in the beginning of chest department to an arch of an aorta the gullet is located to the left from an average line.

At Complications Illness (an Ulcer, A Bleeding), To

At complications illness (an ulcer, a bleeding), to the expressed hernia a diaphragm aperture, and also unsuccessfulness of long conservative therapy accepts - surgical treatment. Carry out on Nissenu. Operation consists in department of a gullet a wall of a bottom of a stomach. A stomach fix to a diaphragm around apertures several seams. Good results are noted more than at 90 % operated. PEPTICHESKY ULCERS OF THE GULLET Peptichesky ulcers of a gullet make about 1,5 % of diseases - drinks and a gullet. To thicket men, - mainly average and advanced age fall ill-. Aetiology and : in development of an ulcer of a gullet action the factor matters. Disease is often combined with a stomach ulcer of a stomach and a duodenal gut, with a hernia diaphragm apertures, a congenital short gullet, observed after the operations breaking function physiological , after imposing ezofagogastro-anastomoza, i.e. In those cases when there is a zheludochno-gullet th a reflux. Presence at sick infringements of nervous regulation a wall and changes in the central departments of nervous system (in a cerebral cortex, gipotalamiche-skoj areas, a grey hillock) is doubtless.

The Way Spasokukotsky Is Updating Of A Way

The way Spasokukotsky is updating of a way Zhirara - and differs from it only that to to a sheaf - muscles internal slanting simultaneously file and cross-section together with the top rag an external slanting muscle of a stomach At this way the sheaf is less injured . Seam of Kimbarovojugo. Provides connection of the fabrics with the same name. By means of this seam the edge of the top rag an external slanting muscle shrouds edges of internal slanting and - cross-section muscles. The first introduction of a needle is spent on distance by of 1 sm from edge of the top rag an external slanting muscle, then, having spent a needle through edges of muscles, stitch again at the edge the Same thread stitch a sheaf In comparison of the fabrics with the same name is provided. The way Bassini - provides strengthening of a back wall - the channel. After high removal of a hernial bag seed remove aside and under it file internal slanting and cross-section muscles together with cross-section a stomach to to a sheaf.

A Hernial Bag, Edges Sew It In A

a hernial bag, edges sew it in a cross-section direction. Hernial gate expand in a cross-section direction - with two cuts through a white line of a stomach and a forward wall of a vagina of direct muscles to their internal edges. P-shaped seams file the bottom rag under top which in a kind separate seams file to the bottom rag. HERNIAS OF THE WHITE LINE OF THE STOMACH The white line of a stomach is formed skintight to each other by bunches of fibrous fibres wide belly muscles. Between them there are cracks and deepenings which can serve as contributing anatomic factors in - formation of hernias of a white line of a stomach. In the beginning through such crack passes , forming -, and then the hernial bag is formed. Hernias of a white line of a stomach seldom happen big, process can sometimes stop - at a stage . On localisation of a hernia of a white line of a stomach can be/over-umbilical, and . Podpupochnye hernias - meet extremely seldom. Okolopupochnye hernias settle down - more often sideways from a navel.

Observe Cases Of Spontaneous Rupture Of A Gullet.

Observe cases of spontaneous rupture of a gullet. Factors contributing to spontaneous ruptures of a gullet, are alcoholic intoxication, an overeating, vomiting during emetic movements occurs simultaneous disclosing , pressure of muscles of an abdominal tension, reduction of a diaphragm and a muscular cover of a stomach, glotochno-pishchevodnyj remains closed. As a result of pressure substantial increase in a gullet there is longitudinal or cross-section a rupture of its wall, more often directly over a diaphragm ( in 95 %, right in 5 % of cases) gullet Rupture arises at attempt to constrain vomiting or at coordination infringement in work specified above as a result of strong alcoholic intoxication, diseases of the central nervous system. Rupture looks like a linear wound is more often, can extend on a stomach. Develops sharp , at damage pleurae - it . At spontaneous ruptures of a gullet the pain arises suddenly (more often during vomiting) in area a shoot, can in area, a back, the left shoulder.