Paralytic intestinal obstruction
Paralytic intestinal obstruction is caused by infectious-toxic, neuro-reflex, neurotoxic effects, impaired serum electrolyte content or a decrease in blood flow in the intestinal wall. Infectious-toxic causes: peritonitis, pneumonia, uremia, acidosis, diabetes mellitus, porphyrin disease and morphine poisoning. Reflex factors that can lead to paralytic intestinal obstruction: postoperative stress, biliary and renal colic, pancreatitis, ovary torsion, large omentum, trauma of the abdominal cavity and retroperitoneal space, myocardial infarction. Neurogenic causes: spinal cord, syringomyelia, shingles, spinal cord trauma. Myogenic paresis of the intestine is a consequence of avitaminosis, hypoproteinemia, hypokalemia, hypomagnesemia, disturbed blood flow in the intestinal wall with portal hypertension, heart failure, thrombosis and embolism of mesenteric vessels. A special form of unclear genesis, affecting the colon, is called pseudo-obstruction (there are clinical manifestations of obstruction, but even during surgery, no obstacles to passage of intestinal contents are detected).
Symptoms, course. Constant blunt abdominal pain in the abdomen with periodic enhancements in the type of contractions, nausea, vomiting stagnant contents. Bloating. The tongue is dry, coated. The abdomen is relatively soft. When palpation - soreness of the abdominal wall in all departments without symptoms of irritation of the peritoneum. The weakly positive symptom of Schetkin can be caused by a sharp swelling of the intestinal loops (pseudoperitonism). With auscultation - complete absence of intestinal noises; Well conducted heart sounds and respiratory noises. At a roentgenological examination of the abdominal cavity organs, pneumatosis and multiple fine and topocecal levels. Oliguria is characteristic, in the blood-leukocytosis. When stimulating the activity of the intestine, there is no effect.
Treatment. Paralytic intestinal obstruction is always a secondary disease. The basis of treatment is the elimination of the root cause: removal of the focus of infection (appendectomy, suturing of perforated ulcers, etc.). With reflex and toxic intestinal obstruction, the elimination of sources of irritation in a conservative way, i.e., drug blockade of all impulses peristalsis of the intestine by epidural paravertebral blockade. Further - stimulation of the intestine: the introduction of reomacrodex, potassium chloride, 20% sodium chloride solution, proeryrin, clam, acetylidine, siphon enema (causes reflex enhancement of peristalsis). It is necessary to introduce a gastric probe, better than a Miller-Abbot probe for aspiration of gastric or intestinal contents. If these measures do not give an effect and there is a danger of shock development due to a decrease in bcc and hypoxia due to high diaphragm standing, emergency surgery is indicated-laparotomy with nasogastric intubation of the entire small intestine and subsequent treatment of disturbed metabolic processes.
The prognosis depends on the underlying disease.
- Surgical diseases
- Abscess
- Abscess appendicular
- Abscesses of the abdominal cavity
- Abscess of the Douglas space
- Intestinal abscess
- Abscess of the lung
- Soft tissue abscess
- Abscesses of soft tissues after injection
- Abscess of liver
- Amoebic liver abscess
- Prostate adenoma
- Actinomycosis
- Aneurysm
- False aneurysm
- True aneurysms
- Aneurysm of the aortic arch
- Aneurysm of descending thoracic aorta
- Dissecting Aneurysm
- Aneurysm of the abdominal aorta
- Aneurysm of peripheral vessels
- Arteriovenous aneurysm
- Aneurimas of the heart
- Appendicitis acute
- Perforation of the appendage
- Appendicular infiltration
- Pielephlebitis
- Atheroma
- Bronchoectasis
- Varicose veins
- Varicose veins of the spermatic cord
- Dropsy of testis and spermatic cord
- Rectal prolapse
- Gangrene gas
- Gangrene lung
- Hemorrhoids
- Hydradenite
- Gynecomastia
- Hernia
- Internal hernias
- Hernias of the esophagus
- External hernias
- Herniated hernias
- Herniated hernia
- Hernia of the white line
- Hernia postoperative ventral
- Herniated hernia
- Rare hernias
- Pincushion
- Phlegmon hernial sac
- False infringement of a hernia
- Hernias with inflammation
- Dumping syndrome
- Diverticulum
- Esophagus diverticulum
- Cervical diverticulum
- Bifurcation diverticulum
- Epiphrenial diverticulum
- Epiphrenial diverticulum
- Diverticulum of the stomach
- Diverticulum of the duodenum
- Meckel's diverticulum
- Jaundice mechanical
- Bile duct stones
- Ventilated stone of choledoch
- Papillotenosis
- Stricture of bile ducts
- Cancer of the head of the pancreas
- Cholelithiasis
- Urinary retention acute
- Zollinger-Ellison syndrome
- Foreign bodies of bronchi
- Foreign bodies of the stomach
- Foreign bodies of the esophagus
- Foreign bodies of soft tissues
- Carbuncle
- Brushes and fistulas of the neck are lateral
- Cysts and fistulas of the neck median
- Colitis ulcerative ulcerative
- Coccygeal epithelial passage
- Cryptorchidism
- Bleeding
- Bleeding internal
- Bleeding gastrointestinal
- Varicose veins
- The Mallory-Weiss Syndrome
- Bleeding into the abdominal cavity
- Bleeding pulmonary
- Bleeding external
- Parenchymal hemorrhage
- Crohn's disease
- Lymphadenitis
- Lymphangitis
- Mastitis
- Putrefactive mastitis
- Acute non-lactational mastitis
- Chronic mastitis
- Megacolon
- Mediastinitis
- Intestinal obstruction
- Mechanical intestinal obstruction
- X-ray diagnostics
- Specific types of intestinal obstruction
- Ingrown throat
- Frostbite
- Local cooling
- Burn
- Occlusion of the main arteries
- Acute occlusion of the vessels of the extremities
- Acute occlusion of mesenteric vessels
- Chronic occlusions of arterial vessels
- Obtiterating atherosclerosis
- Aortic ileal type
- Hips and popliteal type
- Peripheral type
- Occlusion of aortic arch branches
- Occlusion of carotid arteries
- Occlusion of the subclavian artery
- Takayasu's syndrome (absence of pulse)
- Chronic occlusion of mesenteric vessels (abdominal toad)
- Stenosis of the renal arteries
- Obliterating thrombangitis
- Raynaud's disease
- Orcoepididymitis
- Acute abdomen
- Acute pancreatitis
- Chronic pancreatitis
- Acute cholecystitis
- Panaritium
- Panaritium cutaneous
- Paronichy
- Panaritium subungual
- Panaritium tendinous
- Panaritium articular
- Panaritium bone
- Penetrating ulcer of the stomach and duodenum
- Peritonitis
- Peritonitis chronic
- Piopevneumotorax
- Pneumothorax spontaneous
- Postcholecystectomy syndrome
- Perforated ulcer
- Covered perforation
- Bedsore
- Prostatitis
- Wounds
- Fistulas of the rectum
- Stenosis of the outlet stomach
- Fracture of anus
- Urethritis
- Phimosis, paraphimosis
- Phlebothrombosis
- Occlusion of subclavian vein
- Phlegmon
- Furuncle
- Cholangitis
- Electric trauma
- Empyema of the pleura
- Congenital intestinal obstruction
- Atresia of the anus
- Congenital cholangiopathy of newborns
- Pylorostenosis
- Embryonic hernia (hernia of umbilical cord)
- Exstrophy of the bladder
- Dropsy of shells of testis and spermatic cord
- Surgical diseases of the chest
- Congenital diaphragmatic hernia
- Congenital cysts of the lungs
- Pneumothorax
- Tracheophishoprine fistula
- Mastitis of newborns
- Acute hematogenous osteomyelitis
- Peritonitis in newborns
- Acute paraproctitis
- Necrotic phlegmon of newborns
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