Surgical diseases of colon and rectum.

Arteries and veins of the small and large intestine (small bowel loops laid left, transverse colon pulled up; inner layer of the peritoneum partly deleted)

Small intestine (intestinum tenue) loop mesenteric small intestine.

Blood supply of the colon

Ileus occurs in 9% of all patients with acute surgical pathology of the abdominal cavity. The disease occurs in any age, but usually between years. Men suffer more often (66.4%) than women (33.6%). Mortality is up to 17% and is the largest acute surgical pathology of abdominal

Classification. For etiopathogenesis distinguished: 1. Dynamic (functional) obstruction. A.Spastic. Causes: Diseases of the nervous system, hysteria, spazmophylia, dyskinesia, helmint invasion, colon polyps. B. Paralytic. Causes: inflammation of the abdominal cavity (peritonitis), abscess, retroperitoneal hematoma, post laparotomy, trauma of spine and pelvis, reflex effects of pathological conditions extraperitoneal localization (pneumonia, pleurisy, myocardial infarction), mesenteric vascular, infectious diseases (toxic paresis ).

Spastic ileus

Paralytic ileus

Mechanical obstruction A.obstructive. 1. Intraorhannu - Helmint invasion, foreign bodies, fecal gallstones; 2. Intramural - tumors, Crohn's disease, tuberculosis, cicatricial stricture. 3. Ekstraorganic - cyst mesentery, retroperitoneal tumor, Ovarian cysts, uterine tumors and applications. B. strangulative. 1. Nodilling; 2. Volvulus; 3. Strangulation hernia (external, internal). C. mixed. 1. Intussusception; 2. Adhesive obstruction.

By origin: 1. Congenital; 2. Acquired. The level of obstruction: 1. High; 2. Low. The clinical course: 1. Acute; 2. Chronic; 3. Complete; 4. Partially.

Types of mechanical intestinal obstruction. Obstruction due to obstacles: 1 - obstruction, 2 - constriction, 3 – compression, 4 - angullation.

Mechanical intestinal obstruction. Obstruction of blood circulation : 1 - strangulation, 2 – twisting, 3 – turning, 4 - intussusception.

Volvulus of the small intestine

Pinching the small intestine

Nodding and intussusception

Hemodynamic intestinal obstruction (thrombosis, embolism)

Clinical symptoms. In the clinical course of intestinal obstruction are three phases: 1. “Ileal cry"; 2. Intoxication 3. Terminal - stage of the peritonitis

Swollen bowel loops

. Laboratory and instrumental methods of diagnosis 1.Total blood test. 2. Hematocrit. 3. Urinalysis. 4. Biochemical analysis of blood. 5. Coagulogram. 6. Survey renhenohrafiya the abdominal cavity. 7. Healf-glass oral barium test by Schwarz. 8. Iryhohrafy. 9. Colonoscopy. 10. Ultrasound abdomen. 11. Laparoscopy.

Kloybers’ bowls (chart and radiography)

Bowel obstruction (X-ray).

Thinly-colon intussusception

splenic angle of the colon cancer

. Therapeutic tactics and choice of treatment. Tactics for surgery. 1.Drainage of the stomach, cleansing (siphon if necessary) enema, antispasmodics, perirenal blockade. All activities should take no longer than two hours after the admission of the patient to the hospital. 2. In the case of ileus resolution after conservative treatment the patient is fully clinical examination to determine the cause of obstruction. 3. In the absence of effect of conservative treatment shows emergency surgery.

Surgery. Preoperative preparation includes the following procedures. 1.Drainage constant stomach probe. 2. Introduction of drugs for the regulation of breathing, blood circulation and second life- supporting organs and systems. 3. Fluid resuscitation in the required volume controlled CVP. A must is typically three catheters: catheter into the central vein, a probe into the stomach, a catheter into the bladder.

Types of intestinal anastomoses

Probe for nazohastro-intestinal intubation.

nazohastro-intestinal intubation

Drainage intestine through caekostoma.

Jejunostomas

hemorrhoids

Examination of rectum

Anesthesia and dyvulsion of anus

Stages of hemorrhoidectomy

Rectal prolapse

paraproctitis

Remove rectum cracked

Colon Cancer

Radiographs of colon cancer

Endophytic sigmoid colon cancer (X-ray).

Endophytic sigmoid colon cancer

Resection and removal of rectum

Anastomoses of colon

Sihmostoma

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