Intestinal laxity: symptoms, causes, remedies and inappropriate additional help. Through winking of kishkova lack of connectivity and how much? Kishkova lack of deterioration

Update: Leaf Fall 2018

Gastrointestinal imperfection (shortly OKN) є an important surgical pathology and enter into the list of gastric surgical ailments: appendicitis, cholecystitis, perforated slope of the slurry, and pinched girdle. OKN is not easy to end with a lethal result, the signs of this pathology are responsible for the appearance of both a doctor and a medical staff.

Statistical data

• The lethal result of an operative treatment of KN reaches 20%, and with the development of important forms of 30 - 40%;
• OKN to become 8 - 25% of surgical pathology;
• The death of patients during the development of plump imperfections is likely to occur in 40 - 45% of cases;
• Adhesion of the small intestine will end with a lethal result in 70% of cases;
• OKN in particular cholovich status grow more often and become 66.4%;
• KN is diagnosed in the summer (about 60 years) in some cases.

The meaning of the term "intestinal obstruction"

Intestinal imperfections are called a syndrome, in which case the passage (penetration) into the intestine along the sides is broken herbal tract as a result of obturation of the intestine, pressure, spasm, collapse of blood circulation or intestinal nerves. KN is rare for self-inflicted illnesses, more often it develops in case of pathologies of the intestinal tube, that is, it is not common.

Classification

Isnu ineffective classification of intestinal imperfections. The homeowner gets involved in the following:

For morphological and functional factors:

• Dynamical (synonymic functional) KN, if there is a mechanical transition, which complicates the passage of the intestinal space, the intestinal activity is disturbed. Have your own house, dynamical KN last for:
  • paralytic - a decrease in the tone of the intestinal muscle cells, peristalsis during the day (to suffer from abdominal injuries, including laparotomy, injuries of the extra-urethral space due to hematomas, peritonitis, major metabolic syndrome - small pains);
  • spastic - the tone of the intestinal myocytes, the intestinal stinka on the occasional delay, it is possible to speed up, and the wine is sent by the court either intoxicating, for example, lead, toxins of worms or spits.
• Mechanic KN - occlusion (lack of leakage) of the intestinal tube in the yak-nebud dilyantsi. Addressed to:
  • strangulation (in Latin strangulation - tse strangulation) - to develop when the intestinal breech is compressed, in which case the intestinal vitality is destroyed. Pidvidi strangulyatsiynoi KN: volvulus (intestinal loop to wrap around itself), nodularity (forming the university with decilkokh intestinal loops) і duck (to be promoted when interconnected in the grizzly gates of the intestine itself).
  • obstructive (meaning blockage of the intestinal lumen) - to form when there is a mechanical transition in the intestinal tube, as it is infused with humus. Pidvidi given by KN:

a) VNUTRISHNOKISHKOVO, as it does not tie with the intestinal wall (gum calculus, bezoar - a lusty breast, which can be adopted by females, who may cause a little gritty stone of hair, helminths, feces);

b) VNUTRISHNOKISHKOGO, maє ligaments from the intestinal wall (new solution, polypy, cicatricial stenosis of the intestine);

c) posture (swelling and brushing of the abdominal organs).

- change (strangulation and obturation to admit), as a substitute for:

a) іnvagіnatsіyu (in the lumen of the intestine, food is drawn in, or lower-lying її dilyanka);

b) adhesions - the intestine is pressurized with abdominal adhesions.

• Sudinna abo hemostatic KN - poured with thrombosis or embolism of Brigov's Sudin with a given blockage. At the same time, when there is a collapse of intestinal vitality and a diagnosis of necrosis, there is a problem with mechanics for the passage of every day (on the basis of a parallel CI, but on the cordon, there is also a mechanical problem). The causes of hemostatic KN are atherosclerosis, hypertensive ailments, portal hypertension. Most often, such a KN is able to carry out surgery in young patients and end up with a lethal result in 90% and more cases.

Over the course of:

• Gostra KN;
• Recurrent CI;
• Chronic KN (often promoted to the old age).

For rіvnem znakhozhennya pereshkodi:

• Visoka or small bowel imperfection;
• Low intestinal imperfection or colonic.

Falling from the ruined rukhu chimus step:

• povna KN,
• Chastkovo KN.

For walks:

• vrojena;
• Pridbana.

causes of pathology

Provokuvati development of OKN can change and achieve numerical reasons, as can be seen from the classification. all ethiological factors to screw on and roll on. Friendly factors open or loose the looseness of the intestinal loops, or loose it. Some of the processes in the breech of the intestinal tube and the loop take a pathological position, which leads to the destruction of the intestinal cavity. Friendly factors are divided into:

anatomical:

• adhesions in black empty;
• Meckel's diverticulum;
• Brizhi pathology (overwhelmingly if it sounds);
• Open in the brigi;
• Gryzhi zovnishni (groin, stegnovy, white lines of the abdomen) and internal;
• Bowel malformations (dolichosigma, collapse of the intestine and іnshі);
• New intestine and susceptible organs;
• Quiches of queues.

functional:

• The re-eating of the trivial hunger is the rewarding of the great amount of coarse and gruesome sniffing, the intestines are fast-paced, which can be brought up to KN. For Spasokukotskiy such OKN is called “ailing hungry people”;
• number;
• Craniocerebral and spinal injuries;
• Psychic trauma;
• insult;
• Dysentery and іnshі stanii, for which the intestinal peristalsis is significant.

With a change in the motor function of the intestinal tube in the direction of spasm or paresis of the muscles, talk about the reasons for this: a short intracranial grip, re-entanglement of the herbal tract, intercourse of physical activity (parasitic activity)

Mechanism of development of KN

The pathogenesis of intestinal imperfections includes the back and the muscles. The development of mechanical intestinal imperfections in a stepwise manner (muscle changes):

• Intestinal motility serpent

At the early stage of KN, peristalsis burhliva is indicated - an unsuccessful test of the intestine is podolati vyniklu pereskodu. Because of the significant weakening of motor function, peristaltic speed becomes more and more weak, in the stage of intestinal obstruction, the intestines become more paralyzed.

• ruin vs mocktuvannya

soaktuvannya living talk in the intestinal tube, there is a sharp decrease in the amount of hygiene, hyperextension and deterioration of the microcirculation. Below the pereshkodi there were sleeping gut loops, in which they did not break down. Chim vishche is localized pereskoda, tim shvidshvayutsya signs of intestinal imperfection and the zagalny camp will go down. Deterioration of vmoktuvannya at a high KN develops quickly, and at a low, the hour is not awesome.

• gut

If there is a lack of leakage, ridina and gas accumulate in the intestines. On the cob stage, they re-ferment gases, a little bit more than three KNs, it’s more time to accumulate, a warehouse of such ideas with herbal juices, gruel masses, cobs spread out and rot in the distant blood into the transudate through the intestinal penetration. Ridin and intestinal gases should be produced up to intestinal swelling, so that blood circulation in the intestines and intestinal atony occurs. In parallel, it grows parallel to the collar's press two-fingered intestines As a result, they were placed in the place of the small intestine, they were consumed in a slunker and a bloody vomit, yak called fecal.

• Accumulation of peritoneal exudate

It helps to avoid strangulating problems, when there is a congestion of blood, lymph in the intestinal wall through the clenching of Brigov's vessels. In exudates, there is close to 5% of the stock, and its warehouse is similar to that of blood. On the cob stage of the OKN, the exudate is prozorium and bezbarvny, when it becomes hemorrhagic. The penetration of the intestinal stink of the build-up through hyperextension, so that it is not only blood cells, but microbes and toxins that can be produced before penetration into the vipit. The insight is growing dark and dark, in neglect, brown and black.

Pathogenesis of retinal debris in case of AIC of accumulation of second water, electrolytes, bile and enzymes in the great quantity, destructive acid-leaching stun (CLS), bacterial factor and intoxication. The variability of overwhelming losses is proportional to the respect and the level of KN and the triviality.

• humoral damage

Amused by the second significant amount of water and other necessary words, as a result of bloating, as well as because of the loss of blood in the empty stomach and in the middle of the intestine. On the cob stage, a high KN develops a shortage of calories and chlorides, which grows as a result of the growth of calories from the sow. Low calorie in plasma to produce alkalosis, trivially waste blood and electrolytes to change the volume of circulating blood, so to produce blood pressure and shock until the blood drops.

At the lower stage of the OKN, the balance of the water-electrolyte balance and the acid-base balance is lost. To fix the burning of glycogen stocks, then the fat and blood drop to the body, so that the fatty tissue and the accumulated products are reduced to a decrease. The blood grows in the place of acidic metabolites and acidosis develops. Through a drop, the blood from them vivilnatsya kaliy and grows it together in the plasma, so that you can bring your heart to the heart. At the same time, there is a build-up in the blood of the sechovina.

• autointoxication

Surprised by stagnation in the intestinal tube, increased ferment and gnarish mass, active growth of bacterial flora and the appearance of bacterial toxins by it. Also, autointoxication is associated with the massive synthesis of amiaku, indolu and skatole.

• painful shock

Most often, it is more difficult to prevent strangulation, so as to pressurize the intestine and produce up to the reduction of the number of nerve elements, and provoke the increase. Microcirculation in the intestine and central hemodynamics will immediately break down.

key picture

Prior to the provincial symptoms of intestinal laxity, the following should be noted:

• Pain in the abdomen (may be at 100%)

Abdominal bill є first and by ourselves I will familiarize myself with OKN. V cob stage bіl be of a similar nature and localize in thіѕ area і of the abdomen, de vinikla pereshkoda. I’ll grow old and dull, and I’m dying all my life. At the terminal phase, the intensity of the majority of the symptoms changes.

• Blues / nudota

Є Inconsequential signs of Windows and Mayut sometimes in 60 - 70% of classrooms. The variability and frequency of blues occur at the level of KN, which are more intense, the more intense the blues. There is a lot of bloating masi to revenge slunk in the place of the gut, because of the intestines in them, and the bloat smells out. With obturation of the intestine, the blues do not immediately appear, but it just appeared, it becomes uninterrupted.

• Covering viporozhnen and vіdkhodzhennya gazіv

Characteristic symptoms of CI, which appear early with low CI. In the case of a high degree of control, for an incomplete closure of the intestinal lumen in the cob stage, there can be an independent style and part of the supply of gases. If there is no reason for gas and style, do not bring any relief or loss of food.

• Health and asymmetry of the abdomen

Denmark is the most characteristic for obturation KN. At times of poorness of the small intestine, it is more difficult to increase the level of emptyness, while at the same time, when there is a lack of deterioration, it lives on one of the boxes and becomes asymmetric.

Conducting an out-of-the-box look and objectivity of the ill allow for assessment:

• Zagalny camp

To lay down from the pereshkodi in the intestinal tube, form the KN and the triviality of the disease. At the early stages of KN, during the obturation of the patient's stance, it becomes obtuse, but in the case of strangulation of the intestine, it’s too fast to get sick in the first year.

• the position of the sick

Lyudin from KN took on the position, lying on the knee, with legs bent in the knees and pulled to the abdomen. The patient is restless and throwing up as a sharp pain in the abdomen.

• Tila temperature

At the cob phase of pathology, the temperature becomes normal, or it decreases (35.5 - 35.9), which is spontaneous with strangulated KN. In the world of the growth of CN symptoms (development of peritonitis), the temperature rises to febrile numbers (38 - 38.5).

• Heart rate is very fast and vise

The pulse is partly, and the indicators of blood pressure decrease, which indicates the development of shock (hypovolemic and septic).

The key picture of the KN will be turned up by the appearance of water and change of motion. Mova dry, yak shchitka, coverings with zhovto-brudny nalot, z company unpleasant odor(For small bowel problems - feces). At the terminal stage of the mucous membrane, they develop from the more advanced forms of aft (wounds). These are signs to talk about the importance of intoxication, dehydration and peritonitis.

Retinal examination, palpation, percussion and auscultation of the abdomen allow the pathognomic symptoms of CD to be revealed:

• palpation of the abdomen

Superficial palpation is painless, inappropriate views viklikє yogo gliboke promatsuvannya, when there is a potential for new products in the black empty, or invaginate. Also, a look around and palpation of the cranial wall gives the possibility to appear in the young mountains, when the cranks are pulled through the wall, when the muscles of the cranial press are visible, visible through the eyes.

• sign of Tevener

The vice is lower than the umbilical fossa by 2 - 3 cm, where the root of the small intestine is located, the wicker bile. A positive sign is susceptible to volvulus of the small intestine.

• Anshutz symptom

Zduttya abdomen in the club area on the right - when developing a low KN.

• Val's symptom

On palpation, it starts to inflate to produce a loop, the yak is contoured through the anterior wall of the abdomen.

• promotion of the invaginate

Call in the area of ​​the іleocecal kut at the viglyadі of the wiggly knitted illumination, similar to a sausage.

• Sklyarov's symptom

You can visually, shake the wall with your hand - you can see the “noise of splashing”.

• Hose symptom

Peristalsis visible through the eye is the anterior cherevna stinka "virus".

• Spasokukotsky symptom

Listening to the abdomen with a phonendoscope gives you the opportunity to feel "the noise of a falling speck".

• Auscultation

Burkhliva peristalsis, rіznі noises. Progression of the disease leads to intestinal necrosis and knowledge very quickly, which is called a symptom of "deathly silence".

• Loteson's symptom

Auscultation of the abdomen allows you to feel a dizzy and hearty noises.

• percussion

The appearance of a black wall of the form is a dzvinky sound (tympanic). High tympanitis with metal vidtink is called a symptom of a balloon or a symptom of Kivul. In gently sloping mistsyah (on the sides of the black empty space), it is indicated that the sound is dull.

• Typical symptoms of infection
  • symptom Tilyaksa - paroxysmal severe pain in the abdomen;
  • Rush's symptom - the promotion of elastic and slightly painful illumination in the black empty with the appearance of tenesmus (gracious positives for defecation);
  • Cruvellier's symptom - blood vision from the rectum;
  • the symptom of Babuk is when the intestinal clasps are carried out instead of watching the meat of the meat.
• Symptom of the Obukhivskiy polycarbonate abo the sign of Grekov

The anus is zyaє, the ampulla of the rectum is enlarged, ale instead in niy nemaє. Stimulate with volvulus of the sigmoid colon.

• Symptom Zeinge - Manteuffel

Stimulate with sigmi volvulus. When staging klizmi, it is not advisable to inject more pvlitra of ridini into the intestines.

• Mondor's symptom

Finger up to the back passage to help palpate the rectal fluff, and reveal the appearance of feces in the "raspberry jelly" viglyad.

stages of OKN

The development of the KN State Hotel will take place in three phases:

• reactive phase

Інше її is the name of the phase of the "Ileus cry". Triva 10 - 16 years old and characterized by attacks of the strongest, whistles, pains, which later become permanent. More intensive, to produce a shock mill before development. Between painful attacks є light advances, if there’s a pain, and a sick person’s camp normalizes. Ale, during strangulation of the intestines, there are no state boli to change, and then again become unbearable. Bloating and tediousness in the reactive phase is promoted with a high VF, and for a low VF, it is more characteristic of a decrease in gas dissipation and occlusion of the style.

Pains, when they occur in the early period, are carried to visceral, and accumulated with a sharp spasm of the intestine and enlargement of intramural nerves, so that it is less likely to cause the intestinal paralysis of the intestine to freeze Through the blockage of the intramural end, it becomes permanent and the pain doesn’t seem to be painful (there is a glimmer of light).

• phase of intoxication

The toxic phase develops after 12 - 36 years and is characterized by intestinal paresis, persistent abdominal pain, peristalsis, abdominal swelling and asymmetry. There is frequent bloating as a result of re-nesting of the intestinal tube and slunk. Through the uninterrupted blues of ailments, one cannot drink, a build-up of dehydration: massive injections of ions of Kaliyu, electrolytes and enzymes. Symptomatically, the sickness of a sick person is manifested by a special Hippocrates, dryness in the mouth and unbearable spraying, stove, overwhelming style and gas. There are symptoms of teasing of the queue, Valya, Sklyarov and Kivulya, and there is a shortage of pechinkov. Through the overfilling of the intestine with ridinoy and gases, the stench is repaired to sweat into the empty stomach, which leads to peritonitis to the cob.

• thermal phase

The transition of the OKN to the final (terminal) phase is added through the second to finish the ear of ailment. The camp of a sick person is roztsinyutsya yak heavy or in the land heavy, the growth of polyorganna lack. Dyhannya is becoming frequent and superficial, the build-up temperature is up to 40 - 41 degrees (intoxication with bacterial toxins), creeping up to seeming (anuria, as a sign of malignant deficiency), bloating, intestinal inflammation parts, ale mlyaviy. Bloat vinnikє periodically and there is a smell of feces. The development of peritonitis leads to the diagnosis of sepsis, the importance of intoxication and the lack of all organs and systems will end with the death of the sick person.

Okremi formi / pidvidi KN

The surplus of KN in older adults can be seen for symptomatology in the presence of pathological forms, even in the intestines and due to poor health.

dynamical KN

A form is given to be diagnosed in 4 - 10% of cases of KN and amazed with damage to the neurohumoral regulation of the intestinal tube, which will torment motor function. It can be a spastic component or a paralytic one:

• spastic CN

With this type of KN, spasms are trivial for a year - for a dib. The sickness to skarzhitsya on bends b_l at the viglyad_ sutichok, in some cases I periodically vomit in the place of the shlunk. The patient's camp is not awkward - hard-core, ruin of the robot's heart and the mental system and of the whole day. When looking around: language of vology, palpation of the abdomen is painless, the form of it is not altered, tension of the inner muses and symptoms of teasing of the queue of the day. Inodi palpation allows the appearance of the stisles in the intestine. Auscultatory - peristaltic noise. There may be a sign of styling, albeit the appearance of gas, and the occasional release.

• parallel CN

Supravodzhuyu dull, bursting pains all over the abdomen, without singing localization and irradiation. More permanent. In the world of progresuvannya paresis of the intestine, the sick person will become sick. Others, according to the frequency of familiarity of the paralytic KN, in the appearance of the blues, repeat themselves in bagatoraz and ryasna. The sputum of blues is slug-like, along with duodenal and intestinal. Bloating can be streaked with blood as a result of bleeding from the vertebral stalks of the mucus slurry, or from the gostrich bends and erosions. When looking around, it is evident that the abdominal swelling is equal, without asymmetry, palpation reveals the rigidity of the abdominal muscles. In ailments of asthenic statues, the loops of the small intestine are palpated. Peristalsis is not lingering, or even weak, with auscultation of good heart and dull noises. No drink and no gas.

Strangulation CN

Brought to the mechanical form of KN. The essence of the pathology of the field is not only a soreness or a constriction of the intestine, but also in a constricted breech, where there are nerves and judges, as a result, the vitality and innervation of the intestine and rapidly develop. See strangulation:

• bloat

Vidbuvatsya on quiet bowels, like Mayut brigi. The volvulus (twisting) can be seen either behind the axis of the intestine, or along the axis of the breech. Turn around in 4 - 5% of all types of CP.

A) Volvulus of the small intestine

It’s very important to mend, as well as to be very important and important signs. The head symptom is acute pain. For volvulus of the small intestine, the type of gostra and post-vertebral bladder is located in the abdomen and in the prevertebral region. It’s more like a whistle, it’s peristalsis, and it’s unbearable. It hurts to rush about, shout, take up the position. At the moment of intestinal torsion, bagatorazova appears and does not bring lumbar bloom. The sputum of blues is of a reflex nature and takes revenge on mucus and mucus, instead of old feces. The maintenance of style and gas is not a matter of course. The patient's camp is very important, the deterioration of the micro- and macrocirculation is growing rapidly, the exchange of words, electrolytes and intoxications, the vision of slaughter is changing. Swelling lives, the pulse of acceleration, the grip of blood is low.

B) Volvulus of the intestine

So, when the small intestine is twisted, the symptomatology is swirling. The presence of persistent and spastic pain, as they hunt the right half of the abdomen and the puckered area. The bluetongue is immediately obvious, although it can be of a fecal character, in a large number of cases it is more likely to catch gas and defecation. Lives asymmetric through the zduttya in the navel area and the west on the right in the lower part. The rigidity of the mucous membranes is palpable, with auscultation of tympanitis with the metal vidtin, the peristalsis is weakened, the intestinal noises and the auditory are rotten.

C) Volvulus of the sigmoid colon

There are raptors, even more strong pain in the lower abdomen and in the kryzhovoy area. Can be disposable, older than dvorazov bluetooth. The blues become fecal in the world of development of peritonitis. I am familiar with the head є not seeing style and gas. Zduttya abdomen swings sharply, diagnoses its asymmetry: vibuhne right half uphill, through scho live viglyadaє skewed. Through the zduttya of the rim intestine, the internal organizations are fed with a diaphragm, which makes it difficult for the heart and for the robot.

• vuzloupatenyam

It is characterized by a high mortality rate (40 - 50%) when the operation is performed early. 75% grow at night. In the education of intestinal universities most often take on the fate of the small intestine and sigmoid loops. The Danish type of KN is used for the best in the middle of intestinal imperfections. Overcoming pathological importance, rapidly growing symptoms of shock, dehydration and intoxication. The camp of the ailing one is important in the region, rapidly progressing heart-deeply lacking. The patient's skargi has severe pain in the abdomen, repeated vomiting and weakness. Ailment stogne, restless. When you look around you fall into the eyes of the disease and cyanosis of mucous membranes, the pulse is set up, the grip decreases, the abdominal pain is irregular in the case of industrial, in some cases of palpation. Peristalsis is weak, fast-paced. develop gosstra nirkova lack(A collection of olіgurіya, poіm anurіya).

• obmezhennya

To develop when interconnected, whether it is a breech of the intestines in the gates and to provoke overworldly physical changes or a sharp collapse (turn, nahil). Show up as typical symptoms. The mice of localization of the grizzly vine has a swelling bile and there is a swelling of the grizzly, the grizzly starts to get overwhelmed, it grows stressed and cannot be adjusted. Suddenly, a build-up grows, as it can supravodzhuvatysya tediousness and blues, overlap the style and gas. The zanedban situation has a frequent pulse, there is a dryness in the rota, and the mova becomes dry and short, it must have the signs of a queue. Symptom of cough delivery is negative.

obturation KN

The essence of the given form of KN polyaga is in the blockage of the intestinal passage, albeit without the microcirculation in the brigade. Symptoms are zoomed by the causes of intestinal obstruction.

• VNUTRISHNOKISHKOGO (without ligament from the intestine)

Yakscho intestinal enlightenment is clogged with gum stones, in the anamnesis of a sick person є a case of ailment on the gut and attack of pechin coli. In the first place, it will be supressed with cramping pain and vomiting, lack of gas, asymmetry of the abdomen and apparently intestinal peristalsis at the time of the attack. In some cases, palpation of a stone in the intestines is possible. On auscultation, there is a lingering noise from the intestine, and it smells when the intestinal paresis is formed.

It is typical for lithuanian patients, and the residual diagnosis arises in the course of the operation. Klіnіka zvoryuvannya includes: I mean the waste of vagi, I will adjust the temperature, Constipation, diarrhea, abdominal symptoms, bloating and abdominal asymmetry.

• intestinal invagination

The Danish type of pathology is often observed in the form of KN and polyagi at the retracting of the lower intestinal viddila into the viscera (visceral) or navpaki (declining). Іnvagіnatsіya - the process of changes in the type of KN і follow the obturation of the intestine and strangulation її stinok and brijі. It is possible to diagnose in any case, but more often for all such intestinal imperfections to develop in children younger than 5 years and in older people. Vidi іnvagіnatsіy:

• A) small intestine - retraction of the small intestine into the thin;
• B) large intestine - into the intestine, the intestine is inserted;
• C) club-large intestine - the ileum is drawn into the intestine;
• D) invagination of the slunk;
• E) retraction of the small intestine into the slunk.

To tighten up the development of the іnvagіnatsії growth factor, to destroy the motor function of the intestine: constipation, diarrhea, peristalsis burrhliva, intestinal spasms and іnshe.

Mechanism of development of pain and other symptoms of CD in the case of an invasion of the intestinal lumen obturation with invaginate and interrupted nerves and nerves from the intestinal tract. Intestinal infection in children is developed in 75% of cases of all types of CD. Ailments develop raptus, often on aphids or enteritis, or for a reception of laxative wounds. In the classy pictures, they are even worse, in the eyes of the eyes there are more pain, the intensity of such growths and the growth of the strength of the intestinal fast. In the last hour, the pain was interrupted by attacks, and the pain itself became more permanent and less frequent. A painful attack on the supravodzhute blues. Defecation is acquired, but it is less likely to come in the place of the intestinal tract, which is located below the length of the invagination. The style is more often crooked, in the eyes of the "raspberry jelly" and the supernatural is tenesmus. Inspection of the abdomen allows the peristalsis to be visible (the anterior cherevna stinka grows and "virus"). The palpation of the abdomen is painless, but in case of a malaise, the appearance of a sickly and unpolluted sausage form will start. It is located in the right club area, above the umbilical fossa transversely, or in the right edge. Carrying out rectal dilution will allow the expansion of the rectal ampoule, and in some cases (in children) the head of the invaginate, which descends into the rectum. Rectal evidence of blood visions in the anus.

• adhesive CN

The Danish type of KN is on the first place in the middle of all the most difficult ones and becomes 40 to 90% of the total. Tsey view of KN є zmіshanim і provoke with dangling abdominal adhesions. The obturation mechanism of the KN of the accumulation of adhesions by the process, such as deformity of the intestinal loops, and strangulation - with semi-tissue strands, which tighten the intestinal wall or the breeze. Prior to the sign of spike KN, there is a change in pain, boring and bloating, air flow and gas intake. Nash on the thought about the development of the state of the spike KN add to the apparent scar on the abdominal wall, abdominal trauma, or burning of its organs in the anamnesis. When the bowel loop is too tight, there is a pain, which is weak for an hour. The patient's camp in the "painless period" is very important. Yakshho vinikla strangulation of the intestine abo brizhi a further development shock and intoxication.

vrogena KN

As a matter of fact, as a matter of fact, it is obvious that intestinal problems are diagnosed in a child's life, at the first part of the attack from 10 to 15% of all types of CN. The reasons for this pathology are the development of growth abnormalities:

• Defects that were formed during the period of organogenesis (3 - 4 days of vaginosis): atresia, stenosis, lower intestinal loops:
• Defects caused by intestinal innervations and blood circulation: pyloric stenosis, megaduodenum, Girshsprung's disease;
• Rotational vices;
• Defects, in the basis of which lie incomplete bowel rotation - Ledd's syndrome;
• Defects in the development of abdominal organs, diaphragm and pukhlin-like approval.

Vrodzhena KN can be used as a private property. Chastkova KN is supported by:

• To the top of the KN: atresia of the duodenal intestine (DPC), or of the cob ulcer of the small intestine, internal stenosis of the DPC, kelcepodibna of the small intestine;
• Small intestine: atresia of the club intestine or internal stenosis, enterokistoma; true and good old internal grids;
• Low, to what is applied to the development of the rectum and anus.

During the interruption, all intestinal defects are subject to chronic and recurrent conditions.

Additional diagnostics of the genital CN includes an additional test (α-fetoprotein, hCG and estriol), ultrasound examination at 22-24 hours of another level, amniocentesis for the establishment of the karyotype and pre-storage of water. Behind the discouraged results of obsozhennya see a group of middle-class and see food about further prolonged vaginosti or retreat.

The temple atresia of the intestine in the fetus in half of the symptoms is superimposed on polyhydramnios. Shown is the ultrasound scan and amniocentesis. Even in the course of pre-lingering waters in them, there is a high concentration of gum acids - this is a sign of intestinal atresia.

Symptoms of different types of genital KN:

• Gostra visoka KN

I am familiar with the head in the new-born women є the blues are in the mouth, in some cases I am not sealed. Vinnik's bluesє hold out the first to finish off the child's life. Mekoniy is coming, ale of mice of bloating lives in the epigastriya and the western part of the lower endeavors. It is evident that the child has lost her vagi.

• Gostra Nizka KN

Mekoniy does not come in anyway, to be seen in a small number. The blues of the vinnikє on a friend - the third doba, the camp of the new-born one will go down quickly. Lives swelling, soft, sore on palpation. An increase in the lower abdomen is indicated.

• Chronic visoka KN

The blues and prickles appear through a few months of the people’s writing. Ditina has seen physical development.

• recurrent CI

The child of the breast is periodically found attacked by the restlessness, which is superfluous to the abdomen and bloating. The attack can spontaneously learn, and the cleanliness of the class will significantly reduce the camp of the little patient. After training, I will become a period of obvious well-being, triviality in the number of days - a few days, then a relapse of CD will occur.

diagnostics

When you are suspicious for an OKN diagnosis, you need to be able to turn up to a lick. Diagnostics and problems of intestinal imperfections should be taken care of by surgery, such as hearing loss of a sick person, to get an anamnesis, carried out a backward examination of the patient, which includes palpation, percussion and auscultation of living

Laboratory methods of cleaning:

• UAC - it is determined to increase the amount of leukocytes in place of the leukocytes from the zsuvom, the increase in the SHOE, through the dehydration and thickening of the blood.
• Biochemistry of blood - from looking at the deterioration of the water-electrolyte balance and progressive degradation of the build-up instead of nitrogen and blood, glucose and indikana, change instead of calcium chloride and sodium, change
• ОАМ - slice of kalamutna, dark zhovta, the number of її is small, revenge bіlok, leukocytes, erithrocytes.
• Coagulogram is a thickening of blood to produce up to changes in the indicators of the throat: the prothrombin index decreases, the hour of bleeding decreases, that hour of the throat.

From the instrumental methods of diagnostics of KN, it is irreplaceable, accessible and inexpensive є X-ray dosage of the intestine. X-ray of the intestinal tube, including the carrying out of an oblique X-ray at a glance and X-ray of a black empty. In folding vipads, there is a contrast to the pre-detection of the intestinal tube (colonoscopy), as well as the endoscopic pre-detection of the lower intestinal tube (colonoscopy).

Radiological dosage should be carried out in the position of a sick person, standing and lying on the back, lying on the boat. Specific X-ray signs:

• The Kloyber's bowl is the price of buying gas from the overturned bowls that hang over the horizontal ridges. Typical and one of the first signs of OKN. At the time of strangulation of the Kloyber's bowl, it is possible to emerge after 1 year, when a cob becomes ill, and at obturation, after 5 to 6 years. The bowls can be multiplied and one on one faces each other, looking at the sign of the steps to descend.
• The bowels of the arcades are formed in the small bowels, which are blown out by gases, and the lower arcades are formed in horizontal lines.
• The symptom of pennation is to be more susceptible to high CD and puffiness. small intestine, Slizova which will fix the high circular folds. On the sign of the viglyadє yak, a spring with transverse darkness is stretched.
• Contrasting the dosage is a patient viping 50 ml of suspension bar, for which X-ray dosage of the slunk-intestinal tract is carried out in the dynamics (a few signs are displayed through the singing intervals for an hour). To detect impaired motor function of the intestine, it is possible to catch the bar in the intestine up to 4 - 6 years or more.

X-ray signs of KN on the winter ravines:

• small bowel obstruction

The bowls of the Kloyber are small in size, the width of the line is equal to the height of the gas. Rіvnі rіdini in the bowels of the intestines rіvnі. It is good to see the folds of the mucous in the form of an elongated spiral and intestinal arcade.

• Small intestine laxity

Rivni rіdini is located in the middle of the country and in the epigastriya.

• Lack of endoscopy of the club intestine

Equivalent birthdays are indicated in the mesogastric region (middle of the abdomen).

• colonic obstruction

Equivalent births are found from the sides of the abdomen, and their number is less, less if the small intestine is not leaky. In comrade intestines, there are folds of mucus, which are called gausters, and it is good to be seen on gas. The surface of the ridges is not smooth, but ribbed, so there are large feces in the intestine, floating on the surface.

• dynamical KN

Rivni rіdini appear in the small intestine and the rim intestine.

Colonoscopy and sigmoidoscopy are carried out at adolescence for colonic obstruction. Dani dlіdzhennya add to the emergence of possible causes of CN: pudding, fecal blockage, alien tilo.

Differential diagnosis

AOI is similar in symptomatology to a malady, so it is important to carry out appropriate diagnostics with them:

• gostry appendicitis

Similar signs of these pathologies appear in the stomach, such as grief, boredom and bloating, catching defecation and emergence of gases. If, in case of appendicitis, it was localized, and originated in the epigastria, and then descended to the right of the club area, then in the case of the Windows it was more likely to be more similar, more swirling and running through the luminous prominences. It is swept, the peristalsis is visible for an hour and the appearance of characteristic auscultatory signs is heard in case of audible black emptying of the type for KN, and when the appendix is ​​inflamed, it is visible. In the UAC і in case of appendicitis, і in the case of AOI firing changes, ale on the X-ray signs there are signs of CI on the day.

• vyrazka

Vyrazka vyrazka (shlunka abo DPK) is similar to OKN with a raptor cob, swirling abdominal pains, obstructed gas and defecation. When I cut through, the camp of the ailing one grows abruptly, I become restless, I take a pose. He lives with a break in the palpation, similar to a board as a result of a sharp strain of the cranial press, does not take part in the dichanna, it is sharply painful, despite the fact that he is promiscuous. With OKN, there is a soft, swollen, not painful, if the intestinal loop is blown out, peristalsis is strong. Vyrazka not supervise the strength of peristalsis and blues. Radiographically, when perforated viraztsi in the empty abdomen, vilny gas is visible, and with OCH the Kloyber bowl.

• Hostry cholecystitis

To the zagalny ones, there is a sign of lying: a rapid raptus, boring and bloating, swelling is alive. Ale, with cholecystitis, the bile is swiveled in the right edge and outward to the scapula and in the shoulder of the right-handed person. In case of ACH, I have pain in the viglyadi systychok, do not have a clear localization. With palpation, in the case of cholecystitis, in the right ribcage, there is tension in the muscles and soreness, and strengthening of the peristalsis and sound phenomena in the daytime. Also cholecystitis supravodzhutsya due to temperature changes, fiery changes in the blood and zhovtyanitsyu.

• gostry pancreatitis

Pathology from the ACH can be associated with such signs: an ailment sickness, a raptus ear of pain, frequent bloating, gas and blood pressure, abdominal swelling and intestinal paresis. Bile in pancreatitis is rotated in the upper viddylah, and in the operation of the patient, and in AIO it is cramping. With palpation (pancreatitis), the transverse colon is swollen, and blues are frequent and with a small mouth (with AIO with the smell of viporozhnen). The appearance of style and not the appearance of gas during pancreatitis is spared to last for a short hour, the peristalsis is not susceptible, but in the blood and OAM there is a high rate of diastasis.

• Myocardial infarction s abdominal syndrome

In case of myocardial infarction with abdominal syndrome cleverly show guess the strangulation KN. There are abdominal pain, abdominal pain in the upper half, weakness, tediousness and bloating, soreness and gas. Ale on the corny infarction of the myocardium, there is tachycardia, blood pressure, deafness of the heart and percussion enlargement between the hearts. Also, in case of infarction in the abdominal asymmetry, peristalsis, characteristic intestinal noises, is strengthened. Confirmation or to facilitate the diagnosis of a severe myocardial infarction, if it is allowed to carry out that analysis of the EKG.

• Nirkova Kolka

An attack of nirkovy Kolka, similar to AIC, with onset symptoms: severe pain in the abdomen, thirst, stiffness and gas not to enter, the ailment is restless. In the case of a nirkovo colony, it is wide across, between the middle and the body, and is superfluous with dysuric pimples (clogging of the slit, a sickly sevidus, shelter at the slash) and a positive symptom of beating (in the area across). On x-ray signs at nirkova kolki concretions are seen in the cuttings and in the nirkas, with the OKN - in the Kloyber bowls.

• lower lobe pneumonia

Zapalennya lower part of the leg will lead to abdominal pains, nagadu abdominal pains and thighs, scho nagaduє OKN. Looking around a sick person is allowed to put a blush on the cheeks, often on the surface of the cheeks and backwardness, interconnection breast cancer with dichanna on the sides of a burnt lung. With auscultation in the lesions, there is wheezing, crepitus, bronchial discomfort and noise rubbing the pleura. An x-ray sign shows a darkening in one of the lungs.

lykuvannya

With an increase in the development of KN, ailments will require extra hospitalization. Categorically zaboronyaєatsya until lykarskogo look around, put klizma, take in the use of analgesics, to wash the slurry. In older people, KN can be both conservative and prompt, so it can be found in the form of pathology. In the case of dynamic form of KN, conservative therapy is shown, mechanical KN in bagatokh and vimagaє termine operation.

At the earliest (first year) development of the OKN, it is important to ensure that the form is dynamically or mechanically, so that the non-secret operation will last for several years, and only when it is necessary to take conservative start-ups during the day The fault is є the appearance of peritonitis or intestinal strangulation is brought. Until then, conservative therapy can be used to treat the form of obturation of KN (coprostasis) or to overcome the situation with the presence of spike KN or in case of obturation of the intestine to new patients.

conservatively

• Infusion on peristalsis and pain relief

"Quench" reimbursement of pains of additional assistance, carrying out bilateral perinephric blockade with novokain, introducing spasmolytics internally (atropin, drotaverine, spazgan, no-shpa). In case of intestinal paresis with the help of stimulation of peristalsis, preparations are injected, which will increase the speed (neostigmine, hypertonic growth to sodium chloride) and put a clism.

• Decompression of the herbal tract

Including aspiration instead of the shlunk through a nasogastric tube and the setting of a siphon clique (introduced up to 10 years of age). Carrying out decompression is possible only when there is peritonitis. Krіm of dekompressionniє go into sukupnostі of perirenal novokaїnovoї blockade i Introduction atropіnu toil dіagnostichne i predictive value: Yakscho in vmіstі shlunka Je chyme of the intestinal, Tse talk about tyazhkostі patologії and obsyag rіdini scho entered for Relief sifonnoї klіzmi dopomagaє pripustiti rіven tovstokishkovіy neprohіdnostі ...

Decompression of the herbal tract normalizes intestinal peristalsis and microcirculation in the intestinal wall.

• Correction of water-electrolytic solutions and degradation of water

At the same time, massive infusion therapy is carried out (volume of transfusion is to blame, but not less than 3 - 4 liters) Ringer's solution, glucose with insulin, soda (absorption, and paresis in the intestinal tract) is administered intravenously. Infusion therapy is carried out under the control of the central venous vise and dyuresis (catheterization of the clavicular vein and sechivy muscle).

• Normalization of hemodynamics in the intestinal tract

To carry out internal infusion of albumin, protein and plasmas, rheopolyglucine, pentoxifyline, amino acid. If necessary, cardiotropic drugs are administered.

About the effectiveness of conservative therapy to reduce the efficiency of gas and health, the diagnosis of pain and normalization of the sick person. When there is a positive dynamics in a stretch of 2, maximum 3 years, go to extrene promptly involved.

surgical treatment

In 95% of cases of mechanical intestinal failure, surgery is indicated, and only three more than 4% of patients do not succumb to surgical addiction through an extremely important backward camp, and in excess of hundreds of deaths

On the current day, with the development of abdominal surgery, anesthesiological assistance and protozoal visits are contraindicated until the operative engagement with the diagnosis of the AO is only pre-agonal.

Shown before the operation:

• OKN, accelerated by peritonitis;
• OKN with toxicity and dehydration signs (another phase of OKN);
• Symptoms, scho talk about the development of intestinal strangulation.

Preoperative training includes:

• Installation of the post-probe into the slurry pipe;
• The introduction of the drug into the life-saving system is important (mental health, blood circulation);
• Massive infusion therapy.

The basic principle of surgical preparation is the “rule of 3 catheters” (catheterization of the cuticle, slunk and central vein). Yak zenebolyuvannya more beautiful endotracheal anesthesia, access to the empty passage - the middle laparotomy with further extensions if necessary, in the case of grizzling, muscle anesthesia or spinal anesthesia is allowed.

Head of surgical involvement:

• Revizia of the organs of the abdomen

It is important to look around the intestinal loops, moving them from the protection and beyond the help of the vologic servet. The type of KN is established, in the case of the small intestine - KN of the temporalis, distended loops of the intestine - low.

• Usunennya reasons for failure

There is a risk of growth of adhesions and gryzhovykh vorit, in the case of an increase in the number of cases and an increase in intestinal necrosis and during a day of necrosis of the intestine.

• Assessment of the health of the intestine

The gut of a bluish and burgundy color, the breeze is smooth with single hemorrhages, the pulsation of the vessel is spared, thrombi is thrombotic, the peristalsis is normal and the reaction to warm fiz. rozchin - intestinal hyperemia, activation of peristalsis and pulsation of the sudin. Negative intestine (pidlyagaє resection) is black or dark blue, the breeze is dark, with many bloodsheds, there are no pulses, there are thrombi, peristalsis and reaction to teasing warm phiz. by the size of the day.

• Resection of the affected part of the intestine

Resection is made of the change of the dilenk with a part to bring the loops to the exit of 40 cm from the necrotic zone and to the part to bring, 20 cm to the zone of the necrotic intestine. Then the anastomosis can be brought in and out by the intestines (bik at bik, end in bik or end in end). As the cause of KN was inoperable puffin, a routine anastomosis was imposed, or an intestinal stoma - ileostomy, colostomy (vivedennya of the intestine to the anterior cervical stoma).

• come in

If the intestinal loops are tighter, decompression of the intestine is carried out behind the aid of nasogastric intubation of the small intestine with a probe, and the intestinal drainage through the intestinal tract enteritis or cecostomy.

• Sanitation of black emptying and drainage

After the completion of the main operative entry (resection of the intestine, insertion of the stoma), the empty passage is washed with sterile rods and drained, and drainage is placed on the anterior wall.

period of operation

After a successful operation, the patients will be transferred to the intensive therapy ward, which, as a minimum, three dobi. Principles for the management of ailments:

• Fight against toxicity, dehydration and infection;
• Korekts_ya heart-vindicators, dichny porusheni;
• Normalization of KShchS (introduction of electrical solutions);
• Polishing blood rheology (rheopolyglyukin, blood plasma);
• Prevention of thromboembolism (fracsipirin);
• Zagalnozmіtsnyucha therapy (vitamins, immunomodulators);
• Fight against paralytic pislyoperatsіynoi KN (stimulation of the herbal tract to the introduction of proserin abo cerucal, setting hypertonic clizmi, electrostimulation).

A) First three dobi

The patient is in the reanimation ward, so that Suvoriy will take care of the postal regime by holding out the first operation with a raised head child. If you have a sickness, you will be able to use a percussion massage for your breast cancer and a dysfunctional gymnastics (normalization of a robotic system). It is recommended to get up early in the bed - stimulation of peristalsis, prevention of congestive symptoms in lesions and thromboembolic diseases. Once successfully carried out postponed operations get up allowed for 2 - 3 dobu. Harchuvannya of the ailing person with a stretch of the first days is parenteral (the introduction of amino acids, fatty emulsions, glucose distribution). Continuous monitoring is carried out - control of the pulse, frequency of dichotomy, aspirations and control of the slurry tank, visualization of drainage. Parallel antibacterial therapy with antibiotics wide range diy, anti-pyretic drugs.

B) Fourth - this dob

With the help of stabilization, the patient will be transferred to the back room. The mode is a post-mortem, a slunk probe is seen, with normalization of peristalsis, a sick person is allowed to self-sustain by a spontaneous and wiped gum (style 1a). Skin dressing changes 2 - 3 days, drainage from the black emptying can be seen for 4 additional days when there is a vision. It is recommended for a sick person to wear a surgical bandage, which is used to replace the seams. People who are busy with physical culture will be repaired on the 4th - 5th day, in the wilderness I will become a patient. As a result of the weakening of intestinal imperfections, the sick bullet was brought to life by the colostomy, so I could look after it. Trivial introduction of antibiotics, vitamins, immunostimulants. The kharchovy ratsion is gradually expanding.

C) Eight - ten dobu

In case of an unstoppable interruption of the operating period, the mode expands to the outbound, with the entrance from the side, the ailments are transferred to the outbound style No. 15. For three months of operation, it is fenced off with fat, gostrich products, pickles and salt, smoked meats and processed foods, as well as vegetables, which are used to produce gas (cabbage), beans. Shvi mark 9 - 10 dobu. A voucher for the stationary was sent by the nobility of the Swiss under the watchful eye of a professional surgeon.

may you expedite

The excess of the operational period can be accelerated:

• Strangulated intestinal loop necrosis

Scho robiti: repeated laparotomy, visualization of the anastomosis with an anastomosis or an anastomotic stomy. Improvement and drainage of the abdomen.

• bleeding

Scho work: repeated laparotomy, revision of the abdominal organs, establishment of the cause of bleeding, and drainage of black waste and establishment of drainage.

• Inability to suture an intestinal anastomosis

Scho robiti: relaparotomy, anti-natural anus, toilet empty, installation of drains.

• Formation of intracranial (interintestinal) abscess:

Scho robiti: relaparotomy, roztin abscess and drenuvannya.

• intestinal fistula

Scho robiti: conservative therapy: treatment of the skin in the fistula with zinc, gypsum-fatty paste, glue BF-6. Less resection of the intestinal loop with fistula and intestinal intubation. Early surgery is shown in the form of high secondary fistulas.

• spike ailment

Scho robiti: relaparotomy, stupid dilution, intestinal intubation. When out of the day, the formulation of adhesions to the operative KN for children, employment of exercise therapy, physiotherapy, dispensary care.

Nutrition

food:
What is the forecast for the development of OKN?

The forecast is to lay down in the lines of surgery for medical assistance, the speed of carrying out an operative treatment and an operation, interruption of the period of operation, in the case of a sick person and a manifestation fellow sickness... The prognosis of unpleasantness for weakened and lіtnіkh ailments, with the appearance of inoperable swelling, which served as the cause of KN, in the case of sickness for medical aid. The prognosis of hospitality during an adequate treatment and / or an operation lasting 6 years from the ear of the KN development.

food:
What is the potential for the development of KN in case of vaginosity and what is the prognosis?

So, the capacity is one of the factors for the formation of AQN. In 70% of the vapors of the won develop in the 2nd - 3rd trimesters, in 15% - in the first 12 months, little by the hour it is low and in the middle period. Formation of pathology from the hour of gestation to the fatal result of the mother in 35 - 50% of situations, and stillbirth reaches 60 - 75%. If the operation of the bull was carried out by stretching the first three years from the ear of the disease, then the death of the woman was less than 5%.

food:
Qi vikoristovuєutsya in the diagnosis of the KN ultrasonic diagnostics of the worms?

So, you can given method flattening, as it allows the appearance of swelling of the abdomen or ignited infiltration. Alle, through the pneumatization of the intestinal loops, the ultrasound scan data is accepted in the reliability of the results of the X-ray examination.

food:
Yaksho є Gostra KN, does it mean іsnu і chronic? What is it that has been zoomed in and out is it necessary?

So, chronic KN is small when there is evidence of adhesions in the black empty or inoperable chubby. Likuvannya can be conservative, even if it is not possible to carry out an operation when the day is out, if there is a skin infection in the empty space, new ones appear. In case of spike ailments, the dissection of semi-tissue bridges is carried out, and in case of inoperable swelling, the formation of colostomy is carried out.

- damage to the passage through the intestines, obstructive illnesses, pressures, spasms, hemodynamic disorders or innervations. Clinically, intestinal laxity is manifested by pain in the abdomen, tediousness, bloating, clogging of the style and loss of gas. In the diagnosis of intestinal imperfections, data on physical conditions (palpation, percussion, auscultation of the abdomen), digital rectal dosage, oglyadal X-ray of the abdominal discharge, contrast radiography, laparoscopy, colonoscopy. With some types of intestinal imperfections, conservative tactics are possible; in інshih vypadkah carried out surgical involvement, by means of how to serve as an update to the passage through the intestines, or else it is introduced, resection of the non-published intestine.

Country houses

Kishkova imperfection (ileus) is not independent nosological form; in gastroenterology and coloproctology, Denmark is developing itself dear ones... Kishkova imperfections become close to 3.8% of all non-slip mills in abdominal surgery. In case of intestinal imperfections, it will break down to permeate in the place (humus) - napivpereparene grub along the herbal tract.

Kishkov impairment is a polyetiological syndrome, which can be thought of for no reason or reason. Chance and correctness of diagnostics of intestinal imperfections є by the most important factors in the result of an important camp.

Causes of intestinal failure

branch new forms intestinal imperfections are overwhelmed by their reasons. So, spastic impairment develops as a result of reflex intestinal spasm, which can be associated with mechanical and painful hematomas in case of intestinal worms, obstructive intestinal diseases, strokes and pneumatic abdominal hematomas, gastric pancreatitis. pneumothorax, rib fractures, myocardial infarction and myocardial infarction. pathological camps. Crimes, development of dynamic spastic intestinal impairment may be associated with organ and functional disorders of the nervous system (TBI, mental trauma, spinal trauma, dysfunctional diseases of the brain.) ), Girshsprung's ailment.

Prior to paralytic intestinal imperfections, cause paresis and paralysis of the intestine, which can develop in the case of peritonitis, operatively engaging in black emptying, hemoperitonium, poisoning with morphine, salts of important metals, D.

In case of different types of mechanical intestinal imperfections, there may be little mechanical transfer to the way of drying grubs. Obturation of intestinal imperfections can be affected by fecal stones, gum stones, bezoar, purchased worms; intraluminal bowel cancer, alien til; with intestinal shrinkage with puffs of organs in the black empty, small pelvis, nirka.

Strangulation intestinal impairment is characterized not only by the pressure of the intestinal lumen, but also by the compression of the breeches' vessels, but it can be prevented in case of intercourse grids, volvulus of the intestines, infection, and nodulation - reversal The development of the given poroshen can be summed up in the presence of the whole breech of the intestine, cicatricial cords, adhesions, growth between intestinal loops; a sharp decrease in mass, we trivialize hunger for a given transfer; rapid advancing of the intracranial vise.

The reason for the intestinal lesions is the appearance of the occlusion of the mesenteric vesicles due to thrombosis and embolism of the arteries and veins. In the basis of the development of congenital intestinal obstruction, as a rule, there is an anomalous development of the intestinal tube (underworld, atresia, Meckel diverticulum and in.).

Classification

There is a small number of options for the classification of intestinal imperfections, as well as developmental pathogenetic, anatomical and clinical mechanisms. It is common for all these factors to stagnate the differentiation of the type to the elimination of intestinal imperfections.

For morphological and functional reasons they see:

1. dynamic intestinal imperfections, yak, in its own heart, can be spastic and paralytic.

2. mechanical intestinal impairment, which includes the form:

• strangulation (volvulus, pinching, nodulation)
• obstructive (intraintestinal, extraintestinal)
• zmіshanu (adhesive leakage, innovation)

3. Sudden intestinal impairment, ampled with intestinal infarction.

At the same time, the growth of pereshkodi for the passage of grub masses grows high and low small intestinal laxity (60-70%), large intestinal laxity (30-40%). Behind the step, the deterioration of the porosity of the herbal tract, the intestinal laxity can be either more or less partly; for a key interruption - a guest house, a food service and a chronicle. For an hour, the formation of a deterioration of the intestinal permeability differentiates the appearance of intestinal laxity, the development of the intestines is tied with the embryonic vads, and also the dabbling (second) of the laxity, summed up by the other reasons.

In the development of gastrointestinal imperfections, there are several phases (stages). In the so-called phase of "Ileus scream", which is common from 2 to 12-14 years old, prevail more and more abdominal symptoms. I will change the first phase of the stage of intoxication from 12 to 36 years old and be characterized by "obvious well-being" - changes in the intensity of reversible pains, weakened intestinal peristalsis. Immediately, there is a lack of gas, clotting of the style, hypoxia and asymmetry of the abdomen. At the initial, terminal stage of intestinal impairment, which occurs in 36 years from the ear of the disease, severe hemodynamic impairment and peritonitis develop.

Symptoms of intestinal obstruction

Independently of the type and level of intestinal imperfections pain syndrome, Bluvota, cover of style and non-separation of gases.

Bile in the stomach have a very unbearable character. For the hour of the day, how to get out of peristaltic sickness, the patient’s person will sing out of the pain, win stooge, take up the development of the position (squatting, knee-jerk). At the height of a painful attack, symptoms of shock appear: blistering of the shkiri, cold pit, hypotonia, tachycardia. Stikhannya pain can be even more familiar with the knowledge of intestinal necrosis and bending of the nerves. After a clear lull, on a friend I will see an ear of development of intestinal imperfection, inevitably peritonitis.

The Іnshim, characteristic of intestinal impenetrability, to serve as a bluate. Especially rich and bagatorazova bloom, but not to bring lodging, to develop with small bowel imperfections. With a handful of bloating masses, there are surpluses of їzha, more zhovch, in the second period - intestinal vmіst (fecal blues) with a putrid odor. In case of low intestinal imperfection of the blot, as a rule, it is repeated 1-2 times.

A typical symptom of low intestinal obstruction is the intake of style and loss of gas. Finger rectal delayed appearance of feces in the rectum, ampoule stretching, sphincter shedding. With a high imperfection of the small intestine, the closure of the style may not be; Dispelling of the underlying intestinal tract is seen spontaneously, or by cliffs.

In case of intestinal imperfections of animals, I respect the health and asymmetry of the abdomen, peristalsis is visible on the eye.

diagnostics

In case of abdominal percussion, in patients with intestinal impairment, tympanitis begins with metal vidtink (Kivul's symptom) and dullness of the percussion sound. Auscultatory in the early phase, intestinal peristalsis, "noise of splashing" appear to be able to; in the lower phase - weakening of peristalsis, noise of falling drops. In case of intestinal imperfections, the intestinal loop is stretched out (Valya's symptom); in the context of the term - the rigidity of the anterior cervical wall.

More important is the diagnosis of rectal and vaginal follow-up, for the help of which it is possible to detect obturation of the rectum, pelvic swelling. The observability of intestinal impairment is confirmed when carrying out instrumental dosages.

When an oglyadovy X-ray diffraction of an empty one, there are characteristic bowel arches (the intestine is swollen with gas), a Kloyber bowl (dome-shaped enlightenment over the horizontal ridge of the ridge), a symptom of feathery (the presence of a transverse intestine). X-ray contrast to the slunk-intestinal tract stagnates in twisted diagnostics. If the intestine is not defective, X-rays can be taken to pass the passage through the intestines or irrigoscopy. Colonoscopy let me take a look distal views intestine, identify the cause of intestinal obturation and in a number of vipads - allow the manifestation of gastrointestinal imperfections.

Carrying out ultrasound examination of a black emptying in case of intestinal imperfections is complicated due to the development of pneumatization of the intestine, protesting in a number of cases of additional help to identify puffs or ignited infiltrates. In the course of diagnostics of intestinal laxity, there is a degree of differentiation from intestinal paresis - preparations stimulating intestinal motility (neostigmin); vikonutsya novocaine perirenal blockade. With the help of the correction of the water-electrolyte balance, the internal introduction of salt solutions is indicated.

As a result of the recent visits to the intestine, the lack of integrity is fenced, then thinking about the mechanical Ileus, which is the result of the term surgical involvement. The operation for intestinal imperfections is based on the weakening of mechanical obstruction, resection of the non-published intestinal dilemma, and the prevention of repeated deterioration of the deterioration.

If the small intestine is unproblematic, resection of the small intestine can be seen with overlaps of enteroenteroanastomosis or enterocoloanastomosis; deinvagination, twisting of intestinal loops, expansion of adhesions, etc With inoperable swelling of the intestine, a routine anastomosis is applied; with the development of peritonitis, a transversostomy occurs.

V during the operational period carried out the reduction of the BCC, disintoxication, antibacterial therapy, correction of the blood and electrolyte balance, stimulation of intestinal motility.

Forecast and prevention

The prognosis for intestinal imperfections is to lay down as a term on the cob and in the course of the treatment carried out. An unpleasant result occurs in case of poorly developed intestinal laxity, in weakened and lint patients, in case of inoperable pukhlins. With a swollen adhesion process in a crank empty, there is a possibility of recurrence of intestinal obstruction.

Prevention of the development of intestinal problems, including quick screening and visualization of intestinal swelling, reduction of adhesions, worm infestation, correct hardening, prevention of non-invasiveness of intestinal trauma.

Intestinal laxity - the problem is broadened, and there is a large number of patients. Infectious proponyutsya useful therapeutic techniques, which allow you to quickly overcome the disease. At the same time, it is necessary to establish the cause, through the yaku, the disease has been found.

General views about getting sick

Lack of gut in the practice of medical practitioners is taught to do it often. See mechanical and dynamic type. Dvіtsі form mayut signs characteristic of volvulus. Tse vid of intestinal imperfections. Ailments can be made in a hospitable form or mlyavo developed in chronicles.

What are the reasons why there may be a lack of mechanical intestinal obstruction? In this particular case, the fahivtsi see offensive reasons:

• chuck gryzhі;
• worms (through them the passage into the intestines is clogged);
• volvulus;
• іnvagіnatsіya (the process of growing the intestines in the intestines);
• the appearance of a foreign body in the intestines;
• approval of spikes and universities;
• the processes of clogging, stockpiling the purchased feces or grubs by weight.

About dynamic failures

The dynamic impairment of the intestine is accumulated with damage, which is associated with intestinal motility. Moreover, it can lead to negative inheritance development of pathology and incapacitation of organs grown in the cherevniy region. Problems can be found in some of the internal organs, the functioning of which without the need for an average recovery of the intestine. At the same time, they are diagnosed with diseases of the function of the nervous system, and moreover, the stench will overwhelm this disease.

Among the reasons that add to the dynamic intestinal imperfections, varto vidіliti: changes of the pathological type, how to pick up the electrolyte balance, and the deterioration of the acid-pool fluid. In a number of cases, small intestine impairment can be the result of an accelerated decrease in the number of cases of organ surgeries. Ailments can be prevented if patients develop adhesions, or ignite ailments, and oppose the slunk-intestinal tract.

Intestinal blockage can occur through those who grudge incorrectly. So, vyglyadayutsya vypadki, if the patient is even more frequent, and great quantities have meat. In addition, in significant debts, you can live fatty, on the other hand, in the whole day, you can live in fresh fruits and vegetables. That needs to be more closely related to his menu.

Constipation and imperfection can occur through those who can accommodate peristalsis, move inside the uterine grip. All negativities must be produced before the intestine is slowed down or interrupted. Constipation of vinikє through the volvulus of the body for the cause of a great dozhini or vuzkosti root of the brijah. The syndrome of obstruction can occur through volvulus of the intestine, such as vina, through impaired intestinal motility.

Obturation of the failure to activate for the coming reasons:

• pukhlina (including goodness);
• kalovi blockages;
• gum stone;
• tangles of ascaris;
• ignition processes;
• intestinal tuberculosis.

Constipation and poor performance in children are willing to eat up little. If you talk about congenital pathology, then the phenomenon is diagnosed in 20% of cases. On the other hand, it is often the case that you end up with an ailment through those children who are mentally ill with small objects. There is a lot of information about it. I mean, it’s impossible to go into self-destruction, so it’s only possible to ruin the situation.

key picture

Gostra kishkova the lack of symptoms is very specific, for those who are diagnosed with an ailment in a short hour's notice. more views supervise pathology in the transition to a large number of vipads, and moreover, it was vinikak rapt. Vona can be cramping, and the intensity of the buoy is unaffected.

Signs of intestinal imperfections are the cause of bloating and boredom. In addition, symptoms may occur:

• zduttya in the stomach;
• gazi;
• constipation.

The low propensity can be realized, and the ailment will start to progress. Tse to produce before the bloating processes become more twisted, and the tediousness grows. In some cases, the patient's mouth may have an unacceptable odor. Gazi do not enter, but accumulate in the black empty space.

It is also practical for all patients with a given diagnosis not to inhale a great number of turns. The whole symptomatology is meant to talk about those who, in terms of the term, need to go in before entering, which are straight on the path of intestinal imperfections. It is also due to the fact that the symptomatology of the power of that chi іnshy fall, the syndrome of impairedness can be contrary to the advancing rank: the rapid development and deeds of reduction, the deeds of growth and decline in the moment of remission.

There is a basic class of intestinal imperfections, even with a large number of characteristic symptomatic signs. In pershu chergu - tse b_l. At the first stage of the development of ailments throughout the intestines, colic symptoms are seen, and by far the exact localization of the syndrome is practically uncomfortable.

For that, as the outgrowth grew up to the singing period, it grows gradually, by the year it will be enough to hunt practically all the empty woods. As a result, in a number of patients, peritonitis may develop, in which the problem is less likely to occur only as a result of surgery. As soon as the obstruction is victorious, the big effect is permanent and does not consume its hospitality.

Kishkov lack of mechanical stability and the appearance of superficial blues. The Danish symptom is called a winnie for the reason that there is a beating in the stomach. Tse is tied together, so you can't walk along shlunkovo-intestinal tract, That is the result of the visit. Low passability can grow into overweight.

Syndrome zdatnyi is characterized by blockage, as it appears in the small intestine (at the upper part of the yogo), due to which there is a bloody vines. Є Infections, if the problem is diagnosed in the lower intestinal tract, the bloating may be lower and lower in intensity.

Dodatkovo about symptoms

Spasmodic and vidy ailments are practical to develop in the abdominal area. A whole symptom of vinikє through the establishment of stagnation of gas and line, moreover, in great parties. Everything should be done up to the impenetrability of the given mas in the anus. Here the spratsovuє is not just a physiological, but a psychological effect.

Zduttya can cover the upper and middle part of the intestine, proteal processes only build up. It is practically not possible to find out what is happening, perhaps a small part of the blues can be promoted, and the processes are minimal and not radically change the patient's status. I would like to classify the types of impairment, but in the middle of a large amount of problems, the intestines are sore. Tse to produce to the brink of unacceptable inheritances: the body grows out and lives in the liaisons, so as to give in to the processes of swelling.

If we live old, we blow up, then when palpation of the vine is a dull sound, which is called cylindrical. Win as a result of hitting your finger on the surface of the abdomen. Vip drops occur, if the loops of the organ stretch out strongly in the patients' loops, and the stench is visible through the curved curvature.

Paralitic intestinal laxity, as and when they are seen, may be characterized by the lack of gas and feces along the back aisle. Fakhivtsi mean, that symptomatic data are not manifested in all types of problems, they are the main ones, so you don’t need to spiral when making an accurate diagnosis. If there is a blockage, then in the lower part of the intestinal tract the mass is clogged early. In quiet cases, if there are passages of obstructions at the upper part of the intestine, the appearance of gases can be realized over a span of several years. In a large number of vypadkіv lіkar napolyagє on the fact that there is a presence of gas, then the onset of intestinal failure is included.

All alimentary presentations of symptoms can be characterized by such additional signs:

• second appetite;
• backward weakness;
• spragoyu.

The intestinal paralysis can lead to a high level of nutritional organism. As a result, there is a great lack of heart. In addition, there may be such negative inheritances:

• gostra nirkova lack of;
• engaging the slaughter in the body;
• lower arterial grip;
• the frequency of the heart rhythm is increasing.

The child has a fever, the protest shows up, hesitates to be more пізніх stage development of ailments. All the prices go through those that feed the bacteria into the gut lining of the intestine, and then into the shelter.

Yaki come live?

What robiti, how do people have an attack of imperfection? In a number of ailments without medical help, it is possible to suspect that such a problem is spared in their body. As soon as intestinal failure has come, the diagnosis is guilty only by a doctor, so it is necessary to safely I will help the shvidka... Most often, only surgery will allow you to overcome the problem, as you look. It is unacceptable to go in for self-cleaning, as it will lead to less rapid improvement in health problems.

Classification of intestinal obstruction is a mechanical type. The same vipadok can be stuck with a way of letting go of the cause of the development. For a whole fahіvtsі we go to the surgical revision. If you see a paralytic ailment, then you need to go and direct everything to the assertion of the first person.

More conservatively, you can use the following:

• victorian antibiotics;
• analgesics;
• sour;
• some of the most painful medications.

All stench is introduced internally. However, they can come in but they are not very effective. Even more importantly, the operation was performed. Vona renew all intestinal functions in the body of people. In a number of individuals, there is a need for visible surpluses, as they can be found in the body.

It is even more common to allow a pardon, if you are blowing in before the help of carried medications. Fakhivtsi accentuate respect for the fact that the world has been shown to be shown, so as to help the patient's camp go to waste. Until then, you can’t turn to a likar, you can’t do anything and drink.

come in

How can you solve the problem? There are 2 options for diagnostics of a type of ailment in a patient: promptly or conservatively. As soon as ailments enter the medical mortgage quickly, when symptoms of peritonitis, volemic symptoms of peritonitis occur, and a therapeutic infusion on the body should be carried out with a combination of conservative methods.

The effectiveness of such manipulations is based on obvious clinical and radiological data. As soon as the patient has a pain syndrome, it’s worth talking about those who have a positive day out. The problem is to reduce the risk of intestinal ryvnіv rіdini. For the reason, scho sosterіgayuyut kіnіchnі or roentgenologіchnі signs of ailment, there is a need to carry out promptly.

Therapeutic come in with intestinal imperfections, straightened on those who need to clean up the cause. Meta polyagaє in usunennye intoxication of lesions, renewal of intestinal motility. The patient is shown the decompression of the slunk, intestines. Within the framework of a comprehensive treatment, carry out infusions, enter the health and wellness and correct metabolic changes.

It is not common for patients in the course of the retreating to show spastic instability. As the doctor sticks to such a diagnosis, how to learn The main reason vіdhilennya, ala і recognized as palіative actions. To a patient for otrimannya quick positive result recommend taking warm baths.

Oduzhannya insists shvidshe for an additional reception of spasmolitics. We are sick of priznachayut ін'єкції. Implant preparations - Papaverine, Drotaverin, Platyphyllin too. The therapy should be carried out strictly on the basis of visualization of the drug without damage to the dose and triviality of the drug.

Yakshcho sposterіgaєtsya paraliticheskoe obstruction, priznachayut electrostimulation of the intestine. Vykonuyutsya cleanliness clizmi, enter ін'єкції Ubretida, proserin abo analogous drugs... If there is a mechanical failure, an extra laparotomy is required. Іnshі accesses vіrіgіdnі, also є spike imperfection.

With the first signs of such a discomfiture, it is impossible to engage in self-indulgence, not to change it into folk methods. You can only mess up the situation. It is necessary to immediately get involved in a special medical mortgage.

Chastkova intestinal laxity is the most frequent chronic pathological process, which is characterized by deterioration of speech disorders in the body. The ailment is often hostile to people of the first generation, the protector is easily diagnosed in new and young women. The main factors in the diagnosis of sickness are the appearance of new nutrition in the intestines of the children, the accelerated development of surgical involvement, as well as when people have a history of adhesions.

Klinichna picture of a similar rozladi is of a periodic nature. The main symptoms may be in the form of a breakdown of style and gas, pain syndrome, attack of boring and blues. I have no symptoms of ailments. In such cases, after an hour of diagnosis, an accelerated, middle and peritonitis appear.

In the diagnosis of such a diagnosis of intestinal obstruction, it is necessary to check the history of ailments and physical examination. At the same time, it is necessary to check the instrumental and laboratory conditions, X-ray photography, colonoscopy and ultrasound scan. Lіkuvannya in large vypadkіv conservatively, store in reception drugs and a touch of childish food.

Ethiology

Chastkova kishkova impenetrability is formed for a number of reasons. Nayposhirenіshoyu from them є protіkannya in humans spike ailments. Osvita spayok, in its own right, can be viclicano decilcom factors. For example, the inheritance of the ignition process, trauma, mutilation of the anterior wall of the black emptying, for example, the accelerated writing of the surgical engagement on the ocherevin. Adhesions should be produced until the intestinal cavity is pressed down, which will impair the ability of non-pereshkodny passage of feces.

Another factor that screwed up the blockage of the intestinal lumen can be the formation of bad and good puffs on the whole body. In a new way, the position of the intestine can be adjusted in the world of its own growth in the loops. However, it is even more frequent to cover the center of the center, by ourselves to cover it up.

The children of Chastkovo have a problem with surgical operations on black empty spaces and pathologies in Budovia. internal organs... In addition to intestinal disorders in newborns, it is possible to have a viclikano in such a way, as an invasion. Tse pathological process, before the hour of what is spastered in vvadzhennya part of the intestine in the small or navpaki.

symptomatology

The clearest manifestation of the disease will be seen in the fallowness of the cause, as it wicked up the belt. In such a rank, with the formation of adhesions in the neoplasm, symptoms є:

• periodic pain in the abdomen, increased intensity;
• destruction of style and vision of gases;
• In some cases, there are blues positives.

Such signs do not have a hospitable character and in most cases they pass independently. In some way, it is more conservative to drink. Ale visoka ymovіrnіst of repeated їkh appear.

As the cause was the puffiness, just because of that it was spread out in the middle of the intestine, the symptoms of partial intestinal laxity may have a growing character. The main signs of analogous vishchevkazanim, only the stench can be enriched with the implantation of a great variety of shkidlivaya yizhi. Some symptomatology is subtle up to the growth of intensity, in the world of that, there is little to be seen in the range of malice or good pukhlin.

Chastkova lack of durability of the intestinal lumen can be changed by periods of rye defecation. Kalovi masi will be mother of a viglyad diarei at the same time, which will be superfluous with a pungent stinky smell.

on in different stages the prevention of similar ailments is referred to as the so-called fecal vomit, with such vomiting, the smell of feces may be smelled. Tse talk about the strongest impaired intestinal function. Peritonitis is not a very interesting picture, when a person suffers from a persistent vomiting, because there is no way to avoid lulling. In such vipadkas, it is more powerful to viscerate and drain the body.

The main feature of the blockage is those that can be re-created at any moment. Zdavlyuvannya blood-bearing vessels by numerical adhesions or step by step to grow chubby to produce signs of gut intestinal imperfection.

diagnostics

The basis of diagnostics visits with such a distribution is laid out by laboratory and instrumental conditions of the patient. Ale, before the їkh visits to the doctor-gastroenterologist, it is necessary to independently go to the following places:

• vivchit anamnesis of life and history of the patient's ailment - to clarify the picture of the form of the ailment;
• to carry out a retreat and physical examination, how to transfer the abdominal swelling, to reveal the manifestation and intensity of symptoms. Finger until you allow the empty rectum.

Laboratory methods of diagnostics field at health:

• zalny and biochemical analysis of blood - for the development of an intermittent ignition process, deterioration of the function of internal organs, as well as changes in blood warehouses;
• microscopic vivchennya fecal mass - for confirmation or to facilitate the manifestation of primed haemorrhages;
• zalny analysis of urini.

Before instrumental methods you can add:

• X-ray - to carry out for detection specific signs frequent failures;
• CT - for more detailed assessment of the intestine;
• colonoscopy - the endoscopic procedure for the maintenance of the mucous intestine;
• Ultrasonic scanning is the main method for confirming diagnostics.

The idea of ​​rejecting all the results is complete, the car indicates the most effective tactics of therapy, as well as taking decisions about the identification of surgical operations.

lykuvannya

Usunennya podbnogo zhvoryuvannya maє is carried out in the minds medical mortgage, On the basis of additional control of the drugs. First for everything, passed on to conservative therapy. In most patients, patients recognize:

• Acceptance of internal introduction of spasmolytics - to be afraid of the price for usunennya of large visions;
• speech for the renewal of normal intestinal motility;
• Correction of the water-salt balance due to the additional internal introduction of Likarsk rivers.

It is not conservative to use a special probe through the mouth through the mouth of a special probe.

In cases of ineffectiveness, certain entries turn up to surgical intervention. When the small intestine is partially obstructed, it is necessary to viscerate the affected organ with the onset of anastomosis overlapping. The reason for the formation of the ailment was іnvagіnatsіya - to carry out a manual or balloon disinfestation. In vipadkah, the form of ailment on aphids of adhesions is indicated by laparoscopy for the development of adhesions.

In case of partial lesions of the intestine through the chuck, a partial resection of the affected organ is carried out, with further vivedis of the intestine to the anterior cervical wall. The price is necessary for the general health of the defecation process.

Absolutely all operations are focused on the renewal of the deterioration of the feces and the assertion of the main reason for the formation of such a disease.

In addition, it is possible to take care of an ailment for the help of a child, or a vikorystannya of folk medicine. However, a few methods are used only for prior consultation with a doctor.

Similar materials

Dynamical intestinal laxity (functional intestinal laxity) is a disease, like a decrease in a significant decrease, for example, an increase in the activity of the affected organ without a mechanical barrier for penetration. During the development of ailments, intestinal congestion often occurs. Among the other forms of intestinal imperfections, it is given to develop in the skin tenth patient. Enemies of people, be it a vikovoi group, it is not easy to diagnose children.

Intestinal laxity (intestinal laxity) is a pathologic stun, which is characterized by damage to the intestines, provoked by pain in the process of innervations, spasms, obstruction or pressures. It is obvious that the ailment is not given by an independent nosology - it will progress towards the last pathology of the intestinal tract. Reasons for intestinal obstruction to reach the developmental problems.

Paralitic intestinal failure is a pathological stun, which is characterized by we will act lower the tone and peristalsis of the intestinal muscles of the people. The tsei stan is not safe in the region, so without a quick diagnosis of this povnotsinny lіkuvannya can become parallich to the organ. Paralytic gut failure is often diagnosed in the middle and senior categories. Obmezhen, as well as status of belonging or of the category, ailment is not.

Obturation of intestinal imperfection is a pathological condition, which is characterized by rupture of the intestines along the intestines as a result of the pressure of the breech. To develop through a section of a total cross-section of the intestinal lumen. Factors, which take the development of obstructive imperfections, can be both internal and external. It is also obvious that the most effective therapy plan will be recognized in the presence of the first cause. As a rule, obturation of intestinal imperfections is assimilated in a surgical way.

Strangulation intestinal impairment - impaired function of the organs in the intestinal tract, which is characterized not only by intestinal blockage, but also by the compression of nerve fibers and by the breech. The pathological camp is even more important, since the state of the state of the disease in a short period of time can accelerate the necrotic singing of the organs to the body, as a result of the destruction of the blood in them. In medical cases, the signs of lyudina died out for twelve years from the primary turn of the clinical signs.

Stan, when you seriously collapse, or if I start to crumple, pushing through the intestines. Infection most often occurs in people who have been kidnapped, as well as in quiet people who have transferred the operation to the slunk or intestines.

In normal intestinal flow through the intestines, fast bowel movements (intestinal peristalsis) will develop. Loss of intestinal peristalsis can be tied up with the weakening of the meat ball, so navpaki - with trivial spasm. The offense of form is admitted to the so-called dynamic intestinal imperfection.

Causes of intestinal failure

As a rule, the dynamism of the intestine is not so difficult to develop:

• firing of operations on organs of a worm;
• accelerated perebig appendicitis, gosti cholecystitis, gross pancreatitis, etc .;
• in case of taking actions (add for anesthesia, opiati, etc.).

The second type of intestinal laxity is mechanical intestinal laxity - winikє if there is a leak in the intestinal muscle.

Vona may be tied with volvulus, nodulation, pinching of the intestine, for example, with trivial starvation and ryatny pryiomy (this is the name of strangulation of intestinal laxity), as well as with mechanical obstruction (intestinal obstruction)

• adhesions;
• fluffy intestines and susceptible organs;
• alien body;
• grizzlies;
• gum stones;
• shaped breasts їzhі, rich grub fibers.

Symptoms of intestinal obstruction

Beat in the stomach- the most common symptom of intestinal obstruction. With strangulation of won, as a rule, winyk gostro, buvako superficially intensive and squeak cramping. With a great volvulus of the small intestine і with nodulation, a painful shock can quickly develop.

For obturation imperfections, it is typical for more pain to build up, but not too intense. In case of intestinal imperfections, there is a lot of localization in the zone of pathological vognischa, because of the old growth.

Painful infusion in case of general necrosis of the intestine, which manifests itself as an important zagalny camp.

blues(With a little bit of gut, with a little gut, and in larger stages - with intestinal vist with fecal odor) - a persistent symptom of high intestinal imperfection. Chim lower (distal) pereskoda, tympanum mensh is intense. In case of low colonic imperfections, the bloat can be widespread.

Covering the style and gas- one of the most important symptoms of intestinal obstruction. Stop the ailment (it is not easy to know the pain of tenesmus) and the intestines will end to no avail.

However, it is necessary to take care of it, but in case of a high lack of deterioration due to cleanliness from the lower intestinal tract, there may be some significant amounts of feces and gases, but at the same time, there is no need for a short period of time.

During the interruption of the gut, the problem may be a guest (more) and chronic (private).

Chastkova kishkova impenetrability is most often surrounded by adhesions or chubby. Symptoms of becoming ill with a large mensh of yaskravі are either lingering in nature, or they are found in viglyadі repeated attacks, spontaneously, or in the presence of conservative drug calls.

But for one of such fireworks, a picture of hostile imperfection can develop. Part of the intestine is often affected by swelling of the intestine, which means that all other ailments will require a thorough cleaning of the intestine.

Descriptions of symptoms of intestinal obstruction

Diagnostics of intestinal obstruction

To confirm the diagnosis in a term-based order, check the radiologic dosage of organs in the empty blood, analysis of blood. Yak dodatkovy method vikoristovoyt ultrasound dosage organs of worms empty.

In case of objectivity in the intestinal imperfections, the tongue is dry, covered with a lot of nalot, the swellings live nervously. The peristalsis of the intestinal loops is visible on the eye.

The dilation of the intestine grows out of the mouth. When percussion, a tympanic sound starts over the cim mice, in the gentle mice you can see the dullness of the purchase of ridini.

On palpation, the soreness spreads. During the hour of auscultation of black emptying in the early term, peristalsis appears, the peristalsis, gurgling, noise of falling drops appear, and moreover, the peristalsis is stronger than the attacks of pain.

At the lower stages at the connection with the development of paralytic intestinal imperfections, noises increase.

When the deterioration is started, the peritonitis is accelerated, the swelling lives, and the ailment begins to appear, the symptom of the teasing of the queue, the more “moving” of the black emptying.

In ailments with a large intestinal imperfection before an hour of rectal obstruction, an expanded empty ampoule of the rectum appears, a syyuchy sphincter.

Likuvannya intestinal imperfections

The ailment with the form of the overwhelm will operate in the extreme order of short-hour preoperative training.

conservatively

In case of food preparation or gastrointestinal imperfections, it is necessary to repair a complex of conservative approaches, which include:

Tsi come to carry out on the basis of correction of homeostasis, stabilization of hemodynamics, renewal of microcirculation.

Stagnation of designated tactics in food production and hostile forms Allowing to kill adhesive intestinal imperfections by conservative approaches more than 50% of ailments.

surgical treatment

Chirurgical treatment of intestinal failure in case of failure of conservative entry of the field into the weakened pereshkodi (growth of adhesions). At the same time, take to respect such factors, as the expansion is transmitted by the state path, the swelling of intestinal paresis and the frequency of relapses.

With a total adhesion process, it is possible to use a secondary viscerolysis and horizontal testing (Noble operation) for additional medical glue during a period of time without applying a seam.

Children who do not wear seams during testing have thin bowel splinters and perforation. It is also not worthwhile to win a part of the test, so it’s not possible to win the opportunity to develop a relapse.

laparoscopy

In the rest of the rock in the diagnosis and treatment of adhesions of intestinal adhesions in bagatech clientele, laparoscopic dosage is well established with success.

The technique of punctual laparoscopy has been broken down, allowing, in the maximum possible terms, with a high accuracy of confirmation, or the diagnosis of gross adhesions.

Viconization of laparoscopic surgeries for the treatment of endoscopy and the possibility of reducing intestinal obstruction and unique laparotomy is greater than that in 90% of patients with a guest adhesions to intestinal obstruction, there is a possibility of reducing intestinal obstruction

Nutrition and advice on the topic "Kishkova imperfection"

food:How difficult it is to enter gas when the stomach is flattened, why can you talk about a small intestinal obstruction?

as follows: Symptoms of partial intestinal laxity: recurrent pain in the abdomen, low intensity; destruction of style and vision of gases; In some cases, there are blues positives.

food:I'm going! I have a nutritional diagnosis of "intestinal obstruction". The mother of my cholovik made a diagnosis, diagnosed a diagnosis, or even said that it was impossible to correct the operation. For a long time, I suffered from stomach pains, constipation, tumultuous and abdominal pain. In the Internet I read that the result of the operation is most often lethal, suppose if weasel is efficient, such a terrible diagnosis and what methods of treatment are there?

as follows: Good afternoon. Intestinal laxity is usually even more serious diagnosis. Intestinal failure will inevitably end with the death of a sick person, without giving him the necessary medical assistance. The operation with intestinal obstruction is indicated if the ailment does not go into it is therapeutic. The operation does not represent a particular risk, and the frequency of fatal results in ailments without peritonitis is extremely high.

food:Privit, me 40 years, for the treatment of endometriosis, hormonal preparations were prescribed for me, as a result, I got in touch with the diseases of gynecology, but the intestines stopped working on their own. For the renewal of the intestines, I started to take "Duphalac". Lives for another day of sleep on the eye until the eighth month of vaginosity. Does Chi mean intestinal obstruction? Until what kind of fakhivtsya slid turns? How can you create it yourself? Thank you.

as follows: Even on the smallest of strong abdominal cramps, you are sure to have no evidence of gas or intestinal imperfections. You should go to the gastroenterologist. Before turning to liquor, fix the drug with Espumizan.

food:My cholovik, 65 years old, was taken to the shvidky with intestinal imperfections. In the chest, there are problems with the intestinal tract. With a stretch of 3 months buv to drive pancreatitis. Strong zakid zhovchi, even more inflamed with hemorrhoids. Brav omez, zhovchogіnnі, lіki for the renewal of the oven, fermentation, etc. The result is poor performance. Without an operation. Yak dovgo dotrimuvatisya kids style 1a? if it is possible to introduce vegetables, juices, what can be repeated? Until what fakhivtsya turn to whiskey and how to create an analysis, why do you get cancer? What recommendations can you give?

as follows: The triviality of a child is your favorite license, but not less than one month. Vegetables can be introduced not earlier than in a month, and in a boiled, stewed or baked viglyad. As a rule, with the help of the doctor's recommendations, the fakhivtsya daniyah will not be repeated. It is necessary to consult an oncologist - gastroenterologist for a comprehensive treatment and prevention of oncological pathology. It is necessary to take care of the children, to spare and regulate the intestinal passages, to empty the intestines.

food:I was told that the adhesions were causing intestinal obstruction. How are you and how can you be sure?

as follows: Adhesions are semi-tissue loops, which can be established between the organs of the void, including those between the intestinal loops. Adhesions can occur as a result of a trivial (chronic) ignition process in a black empty, for example, in a chronic empty one. In some cases, the appearance of adhesions, really, can be the reason for the appearance of intestinal obstruction. The very fact, for serious operations on the black empty, it is necessary to be aware of the activity earlier and strictly follow the recommendations of the driver.

food:Chi buvaє bloody feces i in any droplets?

as follows: Bloating feces can be. Feces can be found in bloody masses in case of distal intestinal imperfections. Bloating feces is pummeled by the time, so in the lower intestine there is a pereshkoda, which does not allow fecal masses to collapse to the anus. Tobto, the feces just fit into the pereshkoda and not be named. In such a situation, you can bloat with feces. As soon as a man has a bloody feces, it’s safe to say “I’ll help you,” because of poor bowel problems, you only need to go to an additional surgical operation. As soon as possible in case of intestinal imperfections, you will not be able to get there by reaching out, people can die.