Radical Operative Treatment Consists In Defect At Prescription

Radical operative treatment consists in defect at prescription of damage of a gullet till 1 days. defect in a gullet wall make two numbers of seams in a longitudinal direction. Tightness of seams and their isolation from infected and a pleural cavity diaphragms, walls of a bottom of a stomach provide round them depending on level of an arrangement of defect of muscles of a neck, a site pleurae, a pericardium. and a pleural cavity for , introductions of antibiotics-, antiseptic tanks, enzymes. The reason of failures of radical operations - is frequent development of insufficiency of seams. Palliative operations (, , , , spaces of a neck, a pleural cavity) are shown at through wounds - of a gullet when time for radical operation is missed, and at heavy accompanying diseases. Recently at gullet punching - was extended a method active and tight -. Thus carry out taking into account a place of damage of a gullet, more often from a cut on a neck, also bring to a punching place a drainage tube which deduce away from an operational wound.

Treatment: Only The Surgical. After Removal Of A

Treatment: only the surgical. After removal of a hernial bag and make a belly wall on a method of Sapezhko or on a method of Mayo. Method of Sapezhko: two longitudinal sections bordering a - hernia, a skin together with a navel. Hernial - gate dissect upwards and downwards on a white line of a stomach to places where it is narrowed and is not changed. Open a hernial bag, set the internal separated from a hernial bag in a belly cavity. from a back - surface of a vagina of one of direct muscles of a stomach. a hernial bag, edges sew it. Separate seams grasping - on the one hand edge a white line of a stomach and on the other hand a part of a vagina of a direct muscle where , create from myshechno-aponevroticheskih rags "thus a rag located - superficially, file to bottom in a kind . Method of Mayo: two cross-section - cuts bordering a hernia - a skin together with a navel. From hernial gate from hypodermic fatty - on a circle distance 5 - 6 see After opening of a hernial bag divide unions, the soldered big epiploon, set an internal in a belly - cavity.

At First The Patient Empties A Bladder, And

At first the patient empties a bladder, and then after pressing on hernial there is a new desire on , and the patient starts to be wetted again. At suspicion on a sliding hernia of a bladder it is necessary to execute a bladder and . Last - to reveal the form and the sizes of a hernia of a bladder, presence of stones in a bladder. Treatment: only the surgical. If not to know anatomic features of a sliding hernia, it is possible to open during operation instead of a hernial bag a wall of a gut or a - bladder wall-. Surgical treatment - the basic method of treatment of external - hernias of a stomach. Operation - it unique possibility to prevent such heavy complications of a hernia, as its infringement-, an inflammation, etc. Operation of not complicated hernias spend on stages: dissect - fabrics over a hernial bag, dissect hernial gate, allocate a hernial bag, open it, set contents of a hernial bag in a belly cavity, stitch and tie up a - hernial bag in the field of a neck, cut a hernial bag and strengthen a belly wall in the field of hernial gate by a plasticity local fabrics or materials.

Research Make So That The Healthy Place Has

Research make so that the healthy place has been investigated in last turn. Rough superficial make to reveal pressure of muscles of a belly wall and morbidity localisation. Research carry out, making easy pressing by a hand on a belly wall. Pressure of muscles judge on expressiveness of resistance which is felt by a palpating hand at a - touch to a stomach. It is necessary to compare a tone of the muscles of the right and left parties of a belly wall with the same name at identical level, conducting research at first less painful areas. On degree of expressiveness of pressure of muscles distinguish: the small resistance, the expressed pressure, pressure-. Pressure of muscles happens is expressed on the limited - small site or has poured character. Pressure of muscles - display a reflex as a result of the - irritation which are starting with , bodies - of a belly cavity. It is the major symptom of an inflammation -. However he can be observed and at disease of the bodies located ( a pleurisy, , a myocardium heart attack, nephritic ), at presence in space of hematomas, abscesses, at bruises of the bottom edges to which muscles of a belly wall are attached.

Expansion Of An Umbilical Ring And Hernia Formation

Expansion of an umbilical ring and hernia formation are promoted by the various diseases connected with increase of intrabelly pressure (a whooping cough, a pneumonia, , a dysentery). Hernias at children happen the small sizes is more often. Symptoms: a belly-ache causing anxiety - of the child, in the field of a navel, disappearing at pressing-, expansion of an umbilical ring. Umbilical hernias at children usually are not restrained, however this complication is possible. Parents of the child should be informed on signs of infringement of a hernia and to explain necessity - of immediate hospitalisation of the child at development of this complication-. Treatment: at small children in process of development of a belly wall probably self-healing at the age from 6 till 3 years, sometimes by 6 years. If the hernia does not give to the child of troubles, apply conservative treatment. Appoint massage, the medical gymnastics promoting development and strengthening belly . On navel area impose a bandage interfering of interiors in a bag.

Presence Zheludochno-pishchevodnogo A Reflux Can Be Confirmed By

Presence zheludochno-pishchevodnogo a reflux can be confirmed by the data rN-metrii (decrease to 4,0 and more low) (see has undressed "Gullet", "- Special methods of research"). Paraezofagealnye hernias subdivide on , , intestinal, intestinally-gastric, . remains, on a place, and through the diaphragm aperture near to a gullet occurs displacement in a stomach or an intestines. Unlike sliding hernias at hernias probably development of infringement. Observe hernias is more often. At hernias the clinical picture depends on a kind and contents of a hernia, degree of displacement of surrounding - bodies. Switching function is not broken (there are symptoms - zheludochno-pishchevodnogo no reflux) gastroenteric or is warm-pulmonary complaints Can prevail. Most often there is a moving to a chest cavity of the stomach, shown by pains in areas and behind a breast, arising after food intake, , an eructation. At infringement - sharp pains, vomiting with a blood impurity are observed. At hernias during time a - thorax reveal in back against a heart shade a roundish enlightenment, sometimes with liquid level.

Pain (at 33 %) - A Frequent Symptom

Pain (at 33 %) - a frequent symptom of a cancer of a gullet. Pains behind a - breast of stupid pulling character arise during food intake-, can in a back, a neck, the left half of thorax. The mechanism of occurrence of pains the various. Pains behind a breast-, arising during food intake, are caused injured - by food of the inflamed wall of a gullet about a tumour and . Stupid pains during food intake - arise at a gullet a tumour. In this case occurrence of pains is connected with the strengthened reduction of a wall - of the gullet, directed on food advancement through the narrowed site. The constant pains not dependent on food intake or amplifying - after meal, are caused by tumour germination in - fabrics surrounding a - gullet and bodies, wandering and sympathetic - nerves, development and . Metastasises in a backbone can be the reason of pains. food and vomiting (at 23 %) appear at considerable a gleam of a gullet and a food congestion over a narrowing place. Emetic weights consist of not digested - food, a saliva and slime, sometimes with a blood impurity.

- A Powerful Stimulator Of Secretion Of Hydrochloric

- a powerful stimulator of secretion of hydrochloric acid. in a stomach synthesise and store mucous membrane cages (corpulent, entero-hromaffinnye, ). Secretion, , grows out of activation 2- on a membrane cages. So-called antagonists 2- (, , , and ) block action and other stimulators of gastric secretion. The mechanisms suppressing secretion of hydrochloric acid: acid "brake", small intestine factors (, , . The antralnyj department depending on contents carries out production of hydrochloric acid cages. Allocated from G-cages stimulates secretion of hydrochloric acid, and its surplus, causing contained department, liberation brakes. At low value <2,0 liberation and secretion of hydrochloric acid stops. On a measure and neutralisations of hydrochloric acid by an alkaline secret glands at 4,0 liberation and secretion of hydrochloric acid renews. There is an assumption of participation of wandering nerves in a braking mechanism of secretion of hydrochloric acid at contained department. Receipt of sour contents from a stomach in a duodenal gut is a stimulator for functions of S-cages.

- Deterioration Of The General Condition Of The

- Deterioration of the general condition of the patient, pain strengthening testify to development of inflammatory process in -, character of a body temperature, short wind and - tachycardia strengthening-, increase in leukocytes, increase . In the absence of treatment patients with purulent die within the next few days. Profuznye bleedings arise at extensive ruptures of a mucous membrane of a gullet by Frequent complication at damage - pleurae is pleurae. At distribution of inflammatory process on a backbone, - covers back and a brain there is a pain at movement of hands, at pressing on awned shoots of vertebras, a headache In the remote terms can develop and the cicatricial deformations of a gullet shown . Radiological research is the basic method of diagnostics of damages of a gullet It begin with survey and at which it is possible to find out an emphysema , expansion of its shade, , an emphysema necks In the absence of air in investigate a gullet with contrast substance in position - of the patient lying on a back, on right and left to a side, on a stomach.

Strengthening Of A Back Wall The Channel By

Strengthening of a back wall the channel by till the normal size internal rings should be an obligatory stage of operation at all - forms hernias. The fourth stage - a plasticity the channel. At a choice of a method of a plasticity the channel it is necessary to consider that a formation principal cause hernias is weakness of a back wall - the channel. Strengthening of a forward wall the channel with obligatory deep rings till the normal sizes can be applied at young men at small slanting hernias. At direct hernias and difficult forms hernias (slanting with the straightened channel, sliding hernias, recurrent) - strengthening of a back wall the channel should - be made. There are some ways of a plasticity the channel. The way Zhirara provides strengthening of a forward wall - the channel. Over seed to to a sheaf sew - at first edge of internal slanting and cross-section muscles of a stomach, and then separate seams - the top rag an external slanting muscle. The bottom rag fix seams on the top rag , forming thus from rags an external slanting muscle of a stomach.

Having Passed Through An External Aperture The Channel,

Having passed through an external aperture the channel, settles down at a root over a sheaf in the form of roundish formation. Cross-section interferes with lowering direct hernias in . Often direct - the hernia happens bilateral. Allocate special group hernias. At these hernias the hernial bag is located between various layers of a belly wall. Allocate hernias when the hernial bag is located between and cross-section , intermuscular hernias when the - hernial bag is located between various layers of muscles and ; superficial hernias when the hernial bag - is located for superficial a ring between an external slanting muscle of a stomach and superficial . Clinic and diagnostics: to distinguish generated a hernia Easy typical the anamnesis is: sudden occurrence of a hernia at the moment of physical pressure or gradual development hernial , occurrence a belly wall at , in vertical position of a body of the patient and hernia reposition in horizontal position of the patient. Patients disturb a pain in the field of a hernia, in a stomach, feeling of inconvenience at walking, the phenomena, and at sliding hernias of a bladder arise the phenomena.

The Hernia Increases In Sizes As A Result

The hernia increases in sizes as a result of a hypostasis and - fabrics, appears skin. Treatment: emergency operation. At an acute appendicitis in a hernia make , in other cases delete a source - a hernial bag. Chronic inflammation of a hernia at a tuberculosis distinguish during operation. Treatment consists in , specific antitubercular - therapy. Source hernias can be inflammatory processes on hernia integuments (a furuncle, skin damage (, grazes, ). In these cases can be made only after liquidation of inflammatory processes on a skin. Preventive maintenance of complications: surgical treatment of all patients with hernias in a planned order before development of their - complications. Revealing is possible at carrying out of mass prophylactic medical examination of the population. Hernia presence is the indication to operation. INTERNAL HERNIAS OF THE STOMACH Internal hernias of a stomach name hit of bodies of a belly cavity in pockets and cracks . To internal hernias carry also hernias.

Survey Of Integuments Of The Bottom Half Of

Survey of integuments of the bottom half of belly wall, foot, buttocks and i.e. Areas for which lymph nodes are will allow to reveal entrance gate of an infection (furuncles, wounds, cracks between foot fingers) If the diagnosis is not clear the last a method is operation During a cut of fabrics under a sheaf find out either the restrained hernia, or the increased inflamed lymph nodes. Thus during operation there is a possibility dangerous complication infringement and to eliminate it. Feign infringement of a femoral hernia the thrombosis of knot of the big hypodermic vein at a place of its confluence of a deep vein of a hip can At a thrombosis of venous knot at the patient there is a pain and painful consolidation under a sheaf Along with it often is defined is available expansion of veins of a shin emergency operation as in case of infringement of a hernia and a thrombosis of venous knot Is shown. At the restrained hernia eliminate infringement of body and make a plasticity in the field of hernial gate.

Specifies The Presumable Diagnosis. Patients With , Ulcers

specifies the presumable diagnosis. Patients with , ulcers and hundred a gullet show complaints to a painful heartburn, an eructation air, food which arise at them or amplify in a prone position or at a strong inclination - of a trunk forward. At development of a stenosis the heartburn decreases, but amplifies . At radiological research define terminal department of a gullet. At research in horizontal position often reveal a hernia diaphragm apertures. The great value directed by the diagnosis has . For a gullet after a burn, the transferred sharp - infection, a trauma the corresponding anamnesis and a - radiological picture are characteristic-. At can arise in the beginning and in the end of meal, there is no selectivity to firmer and dry food, has alternating character, is accompanied by a pain arising at the moment of swallowing and passage of food but a gullet. , as a rule, not plentiful. At radiological research mark infringement of impellent function and about a gullet out of its terminal department, the - disclosing mechanism - is not broken, spastic reductions quite often fancifully - deform a gullet gleam (, a gullet, etc.

To Surgical Treatment Are Exposed 15 - 20

To surgical treatment are exposed 15 - 20 % of patients . Now from all offered operations to the tonic only what are based on idea extramucous . on Gelleru carry out from access, making a longitudinal section we covers of terminal department of a gullet on forward and back walls throughout 8 - Operatsiju Gellera 10 sm combine with or on Nissenu for the development prevention Results of operations at depend on degree gullet changes (change of a motility and a tone, expressiveness of the inflammatory phenomena), and also from carefulness of performance of plastic operation - the disease of a gullet caused - by spastic reductions of its wall at normal function to the Thicket arises at men and basically at persons of an average and advanced age. Makes 6 % from all - functional diseases of a gullet. Aetiology at a number of patients it is caused vistsero-vistseralnymi by reflexes and it is combined with other diseases -(a stomach ulcer, gullet and stomach new growths, a cholecystitis, , a hernia Diaphragm apertures, an atherosclerosis, a stenocardia and ) Thereof it has received the name reflex (secondary) .