Specific types of intestinal obstruction
Separate types of intestinal obstruction . Gall-stone intestinal obstruction. Gallstones, usually 3-4 cm in size, enter the duodenum through the cholecystoduodenal fistula. Characteristic: the age of patients 60-70 years, chronic calculous cholecystitis in history, intermittent pattern of intestinal obstruction (the stone irritates the intestinal wall, leads to spasm of the intestine and the appearance of its obstruction). After elimination of spasm, the stone moves further. Usually, he finally guts the gut about 1 m from the ileocecal angle - in the narrowest part of the small intestine.
Treatment operative - after displacement of the stone in the proximal direction above it, enterotomy is produced and removed. High lethality (about 30%) is due to the severity of the concomitant pathology in the elderly ballroom.
Tumor intestinal obstruction occurs more often when the tumor is located in the left half of the colon. Characterized by the elderly patients, gradually increasing constipation followed by the development of complete intestinal obstruction. When a physical examination, bloating is noted, in the initial stages there may be an asymmetry, a splash noise. Radiological picture: in the initial stage - colonic levels, then with the development of failure of the ileocecal valve (bauginia valve), there are also small intestinal levels.
If conservative therapy has no effect, surgery is indicated. Depending on the general condition of the patient, an unnatural anus on the colon segment is formed closer to the tumor or obstructive resection of the Hartmann type is performed (removal of the intestine with the tumor, the distal end of the intestine is sutured, and the proximal is removed as a single-stem unnatural anus).
Invagination is caused by the introduction of one segment of the gut in another. There are antegrade and retrograde invagination. The cause in childhood can be diarrhea of different genesis, in adults, benign and malignant tumors of the intestine, which, irritating the intestine, increase its peristalsis and lead to intussusception.
Symptoms, course. Pain, vomiting, in the abdomen, a testicle formation is defined, moderately painful upon palpation. The admixture of blood in the feces (such as "crimson jelly"), with progressive ileocecal intussusception, digital rectal examination sometimes makes it possible to detect the head of the invaginate. The diagnosis in this case is confirmed with an irrigoscopy.
Treatment in most cases operative: in childhood, as a rule, disinvagination, in adults - the removal of invaginate.
The prognosis depends on the cause of intussusception.
Adhesive intestinal obstruction occurs in 30% of cases. Spikes can lead to compression of the gut and obstructive obstruction, in addition, massive scars can squeeze and mesentery of the intestine along with the intestinal wall - strangulation obstruction. Spikes also contribute to the development of a curvature. Adhesive intestinal obstruction is often recurrent: usually after overeating, there is an increase in pain syndrome, which is caused by stretching the intestinal wall, reducing the contractile capacity of the intestine and decompensating the passage of intestinal contents. After conservative treatment with aspiration of intestinal contents, the effectiveness of peristalsis can be restored and the obstruction is eliminated. Each re-operation on the abdominal cavity, including the obstruction, leads to an increase in the adhesion process. If the adhesive obstruction is obturation, it is possible to conduct a course of conservative therapy. If inefficiency or strangulation phenomena - surgery. In order to prevent the phenomena of obstruction in the course of the operation, it is possible to use splinting of the small intestine on a naso-intestinal probe 3-4 m long or a probe inserted through the gastrostomy. The shiny loops of the small intestine are carefully laid, the probe is removed no earlier than 2 weeks, when the position of the intestinal loops is already formed. Sometimes an operation like Noble (plication by holding ligatures through the mesentery of the intestine) is shown.
The forecast is doubtful; No operation, including an operation such as Noble, does not eliminate the possibility of recurrence of the 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
- Paralytic intestinal obstruction
- Mechanical intestinal obstruction
- X-ray diagnostics
- 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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