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Diseases of the operated stomach are a consequence of surgical intervention at which anatomo-physiological ratios and interrelations of digestive organs sharply change, and also neurohumoral interactions of a digestive tract with other internals and systems are broken.
Depending on nature of the executed operation allocate two types of postoperative frustration: postgastrorezektsionny and postvagotomichesky.
Practically after each stomach and duodenum operation it is possible to find functional and organic frustration. Clinically significant disturbances note at 30 — 35% of the patients who transferred a stomach resection and at 15 — 34% — vagisection.
Etiology and pathogeny
Developments of diseases of the operated stomach are the cornerstone various disturbances of anatomo-physiological activity of digestive organs. There is a number of the general premises to developing of diseases of the operated stomach.
Essential pathogenetic factor in development of diseases of the operated stomach — nature of the performed operation (the volume and a way of a resection of a stomach, selectivity
and completeness of vagisection). The previous diseases are of great importance, in particular a digestive tract which reduce compensatory opportunities of an organism and create favorable conditions for development of diseases of the operated stomach. A certain influence on forming of diseases of the operated stomach, typological lines of higher nervous activity render. Among patients two main types — strong excitable type (choleric person) and weak (melancholiac) prevail. The strong balanced type practically does not occur among these patients.
The large number of classifications of diseases of the operated stomach is offered. The following classification is for practical purposes convenient.
Classification of diseases of the operated stomach
I. Postgastrorezektsionny frustration
1. Dumping syndrome
2. Hypoglycemic syndrome
3. A syndrome of the bringing loop
4. Round ulcer of an anastomosis
5. Postgastrorezektsionny dystrophy
6. Postgastrorezektsionny anemia
II. Postvagotomichesky syndrome
3. Recurrence of an ulcer
5. Dumping syndrome
The diagnosis of diseases of the operated stomach is made on the basis of the complex analysis of a clinical picture, results of radiological and endoscopic researches, and also accounting of datas of laboratory. Value of these methods for establishment of separate types of diseases of the operated stomach is ambiguous. Diagnosis of a dumping syndrome, hypoglycemic syndrome, postvagotomichesky diarrhea, as a rule, is based on characteristic clinical symptomatology; the leading role in identification of a syndrome of the bringing gut, the gastrostaza and dysphagies after vagisection plays X-ray inspection, and round ulcers — endoscopy.