STRANGULATION PROBABILITY OF THE INTESTINE (histotopogram):
Intestinal obstruction(ileus) - a violation of the passage of intestinal contents through the intestine, manifested by a delay in stool and gases, flatulence, acute pain in the abdomen, vomiting, intoxication. N. can be a consequence of malformations and diseases, i.e., congenital and acquired. Causes of congenital heart failure: malformation of the duodenum, partial turn of the intestine (Ledd's syndrome), atresia, stenosis, doubling of the intestinal tube, aganglion, stitching of the loops in defects of the mesentery, etc. In addition, the causes of congenital N. k. there may be anomalies of neighboring organs - annular pancreas, cystic fibrotic pancreas with pancreatic enzyme deficiency and development of meconium ileus, intussusception.
CLINICAL PICTURE.They distinguish acute (full), chronic (partial) and recurrent congenital N. to. Acquired intestinal obstruction can be mechanical, paralytic, spastic, resulting from invagination, obstruction with fecal stones, tumors, intestinal paresis, peritonitis, adhesions. Acute N. to. Are subdivided into high and low with a various clinical picture. High N. to. (Obstruction of the small intestine) is acute, with vomiting, the edge is an early and constant symptom. Vomit can have an admixture of meconium, bile, blood, and sometimes - intestinal contents. Eating increases the frequency of vomiting, develop dehydration, blood clots and electrolyte imbalance. X-ray examination revealed multiple gas bubbles with horizontal fluid levels, and with the introduction of a contrast agent (iodolipol, propyl iodon, a suspension of barium sulfate), the topography of the upper part of the digestive apparatus is observed. With partial acute small bowel obstruction, these symptoms are less pronounced. With a low H. c. (Large bowel obstruction), on the first day, the child’s condition is satisfactory, then abdominal distension appears, first vomiting of gastric contents and then intestinal contents.Eksikoz and toxicosis are increasing.
For low N. k. Are characterized by: lack of stool, increasing bloating and respiratory failure, despite stimulation of the intestine; on the roentgenogram - multiple bowls of Kloyber in the large intestine. Irrigoscopy clarifies the pathology of the colon. Chronical intestinal obstruction is often caused by severe compression of the intestine (stenosis) and is characterized by increasing exhaustion, periodic vomiting with an admixture of bile, and abdominal distention in the epigastric region after eating. The chair is scarce, alone or with an enema. With an X-ray examination, a suspension of barium sulfate suspension in the suprastenotic section of the intestine is noted for a more or less long time. Recurrent congenital N. k. Arises from partial twists of the midgut, infringement int. hernias, etc., which is clinically manifested by attacks of cramping pain, vomiting, stool and gas retention; attacks can subside on their own.
TREATMENT. Food is eliminated through the mouth, a probe is inserted into the stomach, water-salt metabolism is corrected and the acid-base state is established, parenteral nutrition is established. After a short preparation, surgical operations are performed. treatment - eliminate the cause of N. to.If necessary, resect the segments of the intestine with the imposition of an anastomosis end-to-end or "U" -shaped discharge anastomosis. The intestine must be intubated, continue parenteral nutrition to restore peristalsis and intestinal function.