At Germination By A Tumour Of Returnable Nerves

At germination by a tumour of returnable nerves at patients hoarseness of a voice, defeat of knots - of a sympathetic nerve develops-, the syndrome of Gornera is shown. a wandering - nerve can cause a bradycardia, fits of coughing, vomiting-. Germination by a tumour a nerve is accompanied - by a diaphragm paralysis on the corresponding party, and a humeral - texture - a pain, , and then a paralysis of the top finiteness. Transition of a tumour to a throat is accompanied by change - of sounding of a voice, occurrence of a short wind and breath. At (germination) of a trachea and bronchial tubes there is a cough, a short wind (at 7,2 %). Formation pishchevodno-trahealnogo or a pishchevodno-bronchial fistula is shown by cough at - liquid reception-. This complication usually comes to an end with development of a pneumonia, an abscess or a lung gangrene. Owing to transition of an infection from a gullet can develop , , -. At destruction by a tumour of a wall of a large vessel there are massive bleedings.

For A Cancer Progressing Increase Of Impassability Of

For a cancer progressing increase of impassability of a gullet which at one patients develops quickly, at others - slowly (during 1 1/2 - 2 years) is characteristic. Infringement of passableness of a gullet is connected not only with narrowing of its gleam by a tumour, but can be caused development pe-rifokalnogo inflammations, occurrence of a spasm of a gullet at defeat by a tumour nervous textures. More often the spastic phenomena mark at tumours. In a - disease initial stage arises at proglaty-vanii the dense or not enough chewed food. Patients feel as though its "sticking" to a wall of a gullet or a time - delay at certain level. The water drink usually eliminates - these phenomena. Even well chewed food further ceases to pass, and patients are compelled to accept semi-fluid - and liquid food, becomes a constant and arises even at the liquid use. Sometimes after the proof period there is an improvement of passableness of food on a gullet, connected with tumour disintegration. To occurrence can precede appearing at firm food of sensation of a foreign matter in a - gullet, feeling "" behind a breast, morbidity at defeat level.

Edges Of Hernial Gate Firm Owing To Development

Edges of hernial gate firm owing to development of a dense cicatricial fabric. External covers of a postoperative hernia are presented by a cicatricial fabric, is intimate with a hernial bag, or a skin with hypodermic and a postoperative hem in the middle. - Muscles adjoining - to hernial collars can also - be changed-. The hernial bag quite often happens multichamber, and a hernia . Recognition of postoperative hernias does not represent - difficulties. Detection in a postoperative hem hernial , appearing at , cough, is sufficient for diagnosis statement. For definition of the body which is in a hernial bag, make radiological research of a gastroenteric path. Treatment: the surgical. At the big hernias operation presents difficulties because of unions of contents of a hernia with a - hernial bag and presence of major defects of a belly wall. At small hernias probably closing of defect at the expense of soft fabrics. During operations concerning the big postoperative - hernias apply methods , and methods of the combined plasticity of defects of a belly wall.

It Is Necessary To Exclude Also A Gullet

It is necessary to exclude also a gullet pushing off from the outside tumours - back , an intrachest craw, the aortas, the increased lymph nodes, filled . The important radiological sign a gullet - is its displacement Even substantial growth of the next bodies - long time does not cause as smeshchae-most a gullet in friable connecting it is great enough. and infringement of passableness of a gullet can be caused (cicatricial change - ), arising after inflammatory - diseases of lungs and lymph nodes . In the anamnesis these patients have instructions on sharp and chronic diseases - of lungs, causeless rises in temperature of a body. at them develops quickly. At radiological research - contours of the narrowed site of a gullet equal, are more rare - wavy-, the mucous membrane relief is kept, the gullet wall at swallowing and breath is not displaced, round a gullet the shade condensed is visible. At a gullet tuberculosis a clinical and radiological picture of disease can have a strong likeness with displays of a cancer of a gullet.

Clinic And Diagnostics: The Most Frequent Complaint Is

Clinic and diagnostics: the most frequent complaint is the heartburn or sensation of burning in areas, behind a breast or on a course of all gullet; after a heartburn there is a - pain. Symptoms arise or amplify at a trunk inclination forward (a symptom " a boot"), are caused by influence on the inflamed mucous membrane of a gullet - of gastric or intestinal juice with bile. Attacks of pains can be connected with strong spastic reductions of a gullet that confirms radiological and ezofagoto-nokimograficheskoe research. Pains can in a back-, between shovels, in a neck, jaws, upwards on a gullet, in the left half of thorax. It is almost always marked . At at night can occur - food weights and gastric juice in respiratory ways that causes strong cough. Disease is connected with insufficiency of the switching mechanism physiological and consequently the conditions promoting return receipt of contents from a stomach in a gullet (a prone position, a trunk inclination forward), cause occurrence of the basic symptoms.

Survey Of The Patient In Vertical Position Gives

Survey of the patient in vertical position gives representation - about asymmetry areas. At presence a belly wall it is possible to define the sizes and the hernia form At define a surface, a consistence hernial -, intestines rumbling, at - a sound (, ). Manual research external from the channel make in horizontal position of the patient after reposition of a contained hernial bag. The doctor a forefinger, a skin , gets to a superficial aperture the channel, . inside and a little above from In norm the superficial aperture the channel at men passes a finger-tip. At easing of a back wall the channel it is possible to get freely a finger-tip for a horizontal branch bones that it is not possible to make at well expressed back wall formed cross-section of a stomach. Being in the channel the finger of the doctor at a tussiculation of the patient feels - transfer pushes of an internal - a symptom a push. Both investigate the channel. It is necessary to investigate bodies ( seed , and its appendage).

Characteristic Changes For A Tuberculosis In Lungs Can

Characteristic changes for a tuberculosis in lungs can be absent. The definitive diagnosis is possible only after - with . Treatment: the choice of a method of treatment of a cancer of a gullet depends on level of localisation of a tumour, a stage of process, presence of accompanying - diseases Good results of surgical treatment it is possible to expect in I stage of disease, is more rare in II and III stages. However a gullet cancer seldom diagnose early, the majority of patients address for the help after half a year after occurrence of the first symptoms of disease Inoperable patients happen for two reasons: 1) - germination by a tumour of the next bodies - aortas, tracheas, a lung, in lymph nodes of the second, third order and other bodies (a liver, lungs); possibility of removal of a tumour at the majority of patients becomes definitively clear - only during operation; 2) presence of accompanying diseases of heart, lungs, kidneys, a liver and other bodies in a stage . At a cancer cervical and departments of a gullet the tumour quickly sprouts surrounding bodies and early gives metastasises.

The Pain Results From Short-term - Partial Infringement

The pain results from short-term - partial infringement of contents of a hernia in narrow, an - internal aperture of the femoral channel. . quite often is the first clinical expression of such hernias. Characteristic clinical signs of a full femoral hernia - are hernial in area bedrenno-pahovogo a bend in the form of hemispherical formation of the small size, located under a sheaf from femoral vessels. Seldom hernial rises up and - settles down over a sheaf. Appears hernial - at vertical position of a body, , at reposition disappears, sometimes with rumbling. a sound over - a hernia sign in which there is a gut containing gas. A hernia sign is also the symptom - a push which happens positive even at the initial form of a hernia. At sliding hernias of a bladder can be the phenomena. The differential diagnosis: spend more often between - femoral and a hernia. At to a hernia well probed to a sheaf, especially men at whom the external aperture the channel is easily palpated, - do not have difficulties at carrying out of the differential diagnosis between femoral and a hernia.

Symptoms: Gradually Increasing In Sizes - In The

Symptoms: gradually increasing in sizes - in the field of a navel, a belly-ache arising at - physical activity and cough. At research find out roundish - in the field of a navel in diameter from 1 - 3 sm to 30 sm and more. At the big hernias the sizes of hernial gate can be considerable the smaller sizes, than itself the belly - wall, caused by a hernia. It creates anatomic preconditions for development of such complications, as chronic impassability of intestines, , infringement. In a horizontal position of the patient decreases in sizes or disappears. Through a skin covering , it is possible to notice intestines waves. At hernias define edges and size of hernial gate. At a tussiculation it is accurately defined a push. Umbilical - hernias often happen , at the big hernias the hernial bag can be multichamber. Diagnostics of umbilical - hernias is simple, however it is necessary to mean that small consolidation in the field of a navel can appear ^ a stomach in a navel. All patients with umbilical hernias should - conduct radiological research of a stomach and a duodenal - gut or for the purpose of revealing - of the diseases accompanying a hernia and causing a pain in the top half of a stomach.

At This Time Intestinal Loops Being In A

At this time intestinal loops being in a hernial bag, can be still viable. Before operation it is impossible to establish the diagnosis During operation the surgeon, having found out in a hernial bag two intestinal loops, should to deduce after a section of a restraining ring from a belly cavity a binding intestinal loop and to define character of the arisen changes in all restrained intestinal loop. If during operation it is not distinguished infringement as the surgeon has not examined a binding intestinal loop being in a belly cavity at the patient the peritonitis will develop. The binding loop of a gut will be a peritonitis source . The pristenochnoe infringement occurs in a narrow restraining ring when the part of an intestinal wall opposite to an attachment line is restrained only. It is observed infringement of a small intestine more often in femoral and hernias is more rare in the umbilical. Frustration and in the restrained site of a gut leads to development of destructive changes to and gut punching.

Through A Mouth It Is Blindly Shown At

through a mouth it is blindly shown at small on extent verhne - and gullet departments. Treatment spend by means of a special set . If passes easily, spend the following on a thickness of number. The technique has been improved at application - of metal conductors and hollow -. They give the chance the radiological control for course definition and advancements on a gullet that raises efficiency of procedure and reduces danger of punching of a gullet. under the control it is shown at located , the channel of narrowing expressed expansion when there are difficulties at conductor carrying out. "Buzhirovanie endlessly" apply at presence at patients with tubular, or plural -. To the silk thread entered through a mouth and deduced through , attach rubber tubes of various diameter. Stretching, them spend through the narrowed site and leave at some o'clock. through it is more safely and easier transferred by patients At some patients mechanical expansion cicatricial a gullet can lead to formation .

The Long Anamnesis Of Disease Is More Characteristic

The long anamnesis of disease is more characteristic for , than for a cancer. At a cancer the first symptom usually is , the pain joins later at germination by a tumour of a wall of a gullet and nervous trunks. At the first symptom - quite often is the pain, arises later. at a cancer unlike always has steadily progressing character. For a cancer it is not peculiar plentiful and night . At appetite at the majority - of patients happens is kept, seldom comes considerable on-hudanie. At radiological research of a gullet at a cancer mark narrowings, roughness of its contours, destruction of a relief of a mucous membrane, its walls, there is no considerable expansion and a S-shaped curvature of a gullet, there are no expressed infringements , the gas bubble of a stomach is kept. Crucial importance for diagnosis statement has with aim for - histologic and cytologic research of the received - material. At good-quality tumours of a gullet radiological research reveals roundish defect of filling with equal contours.

A Protective Barrier Of A Mucous Membrane: 1)

a protective barrier of a mucous membrane: 1) " a barrier", covering ; 2) the first line of protection - membranes of cages, 3) the second line of protection - a membrane mucous. The mechanisms stimulating secretion of hydrochloric acid: , , products of digested food, . - parasympathetic nervous system it is liberated in a stomach wall in the answer as on stimulation of wandering nerves (in a brain - phase of gastric secretion), and on local stimulation nervous textures at a food finding in a stomach (in a gastric phase of secretion) Acetyl-holin is an average on force a stimulator of production of hydrochloric acid and the strong - activator of liberation from G-cages. - the hormone, is allocated from G-cages department of a stomach and the top department of a small intestine, stimulates secretion of hydrochloric acid with cages and their sensitivity to parasympathetic and other stimulation. Clearing from G-cages parasympathetic stimulation, albuminous food, cause, amino acids, calcium, a mechanical stretching of a stomach, alkaline value in department.

To Birthday Of The Child Are In ,

To birthday of the child are in , the shoot grows. At brjushinno-pahovogo a shoot the hernia is formed congenital . In case of incomplete brjushinno-pahovogo a shoot on its separate sites arise a kisty-dropsy seed . The brjushinno-pahovyj shoot covering , forms own a cover . - Cross-section a stomach forms the general a cover for and seed . Internal slanting and cross-section muscles participate in about a muscle lifting Anatomy areas. At survey of a forward belly wall from within from outside the belly cavity can see five folds - and the deepenings (pole) which are places of hernias - External a pole is an internal aperture the channel, it is projected approximately over the middle sheaves on 1-1,5 sm above it. In norm the channel represents the space filled at men seed and at women - round a sheaf of Pahovyj the channel passes obliquely at an angle to to a sheaf and has length at men nearby 4-4,5 see Walls the channel a lobby - an external slanting muscle of a stomach, bottom a sheaf, back - cross-section a stomach, top - free edge of internal slanting and cross-section muscles of a stomach.

For The Prevention In A Belly Cavity Of

For the prevention in a belly cavity of the restrained bodies the assistant to the surgeon keeps them by means of a gauze napkin. The section of a restraining ring before opening of a hernial bag as the uninspected restrained bodies will move to a belly cavity together with infected with "hernial water" is inadmissible. The third stage - a section of a restraining ring make under the sight control not to damage the bodies soldered to it from within. At femoral hernias a cut spend medially from a neck of a hernial bag in order to avoid damage of the femoral vein located at of the party of a bag. At umbilical hernias restraining ring dissect in a cross-section direction in both parties. The fourth stage - definition of viability of the restrained bodies is the most responsible stage of operation After a section of a restraining ring and introduction in solution guts from a belly cavity deduce those parts of the restrained bodies which were above a restraining ring It is impossible to tighten strongly a gut as there can be a - rupture its (separation) in area furrows.