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Disturbances of turn of intestines - Diseases of digestive organs at children

Table of contents
Diseases of digestive organs at children
Oral cavity
Diseases of teeth
Malformations of the sky and soft tissues of an oral cavity
Diseases of a mucous membrane of an oral cavity and gums
Diseases of lips and language
Sialadens
Digestive tract
Basic reasons of gastrointestinal frustration
Gullet
Atresia and esophageal and tracheal fistula
Guttural and tracheal and esophageal crevice, inborn stenosis of a gullet
Other diseases of a gullet
Stomach and intestines
Peptic ulcer
Inborn hypertrophic pyloric stenosis
Inborn impassability of intestines
Inborn impassability of a duodenum
Disturbances of turn of intestines
Inborn impassability of a small bowel
Inborn megacolon
Diverticulums and duplikatura
The acquired impassability of intestines
Intestines invagination
Foreign bodys of a stomach and intestines
Motive frustration. stomach and intestines
Anomalies of a structure of anorectal area
Infectious diseases of intestines
Nonspecific ulcer colitis
Illness Krone
Necrotic coloenteritis of newborns
The coloenteritis connected with treatment by antibiotics
Gastrointestinal symptoms of anaphylactoid purpura, gemolitiko-uraemic syndrome
Intolerance of food proteins
Eosinophilic gastroenteritis
Absorption disturbance syndromes
Malabsorption
Immunodeficiency and intestines
Syndrome of "a congestive loop"
Syndrome of a short small bowel
Gee's disease
Sprue after acute enteritis
Tropical to a spr
Whipple's illness, intestines lymphangiectasia, Uolmap's illness, idiopathic diffusion defeat of mucous
Enzymopathies and disturbances of mechanisms of transport of nutrients
Irritable colon
Acute appendicitis
Diseases of an anus, direct and large intestine
Tumors of a digestive tract at children
Hernias of a digestive tract at children
Exocrine part of a pancreas
Pancreatitis
Embryonic development of structure and function of a liver
Diagnosis of diseases of a liver
Cholestatic states at babies
Parenchymatous jaundices at children of chest age
Disturbances of a metabolism of a liver and zhelchevydelitelny system
Anomalies of a structure of bilious ways
Cysts of bilious channels
Cholestasia and diseases of a liver connected with completely parenteral food
Medicinal damage of a liver
Ray's syndrome
Chronic hepatitis
Wilson's illness — Konovalova
Indian juvenile cirrhosis
Damages of a liver at chronic colitis
Cirrhosis and chronic liver failure
Portal hypertensia and varicosity of a gullet
Fatty infiltration of a liver
Cholecystitis
Peritoneum diseases
Peritonitis
Peritoneum hernias

12:27. DISTURBANCES OF TURN OF INTESTINES
Incomplete turn is observed at disturbance of normal rotation of a gut and its fixing in an abdominal cavity. Turn takes place the following stages in normal conditions: 1) from situation in the middle of an abdominal cavity (under a stomach) the caecum moves to the right lower quadrant of a stomach, rotating counterclockwise around an upper mesenteric artery, as around an axis; 2) other departments of a large intestine located at the left follow for blind, passing at first into the right upper quadrant, and then into the right lower quadrant; 3) after completion of turn the descending and ascending gut is fixed to a back wall of an abdominal cavity by means of a mesentery from Treyts's team slantwise down to a caecum. In certain cases turn comes to the end completely, but the mesentery is underdeveloped owing to what mobility of a small and large intestine is broken.
The most frequent disturbance of turn consists that the caecum does not move to the right lower quadrant of a stomach, and sheaves fixing it press a duodenum, causing impassability (fig. 12-13). Owing to shortening of a mesentery of a small bowel in the field of upper mesenteric vessels there is torsion of guts which is shown as the acute or tranzitorny impassability of intestines passing sometimes into strangulyatsionny.

Механизм непроходимости при неполном повороте кишечника
Fig. 12-13. The impassability mechanism at incomplete turn of intestines. The dotted line showed the correct provision of a caecum. At incomplete turn of a sheaf squeeze a dvevadtsatiperstpy gut, and the shortened mesentery promotes torsion of a middle part of intestines. (From: Nixon H. H., ODonnel B.: The Essentials of Pediatric Surgery. Philadelphia, J. B. Lippincott, 1961.)

Impassability begins in upper part of a duodenum, and then takes the lower end, loops. Torsion of guts is found approximately in a half of the patients operated concerning impassability if the caecum at them is in the right upper quadrant of a stomach. At this pathology symptoms of acute or passing impassability of intestines can be observed already at the birth or on the first year of life. In some cases the wrong turn of intestines is clinically shown as a Gee's disease which gives in to surgical correction. At total absence of turn torsion of a small bowel, bifurcation of a stomach, umbilical hernia, phrenic hernia of Bokhdalek can be observed. Wrong: turn is followed by a ring-shaped pancreas, an atresia and a stenosis of a duodenum.
On survey roentgenograms unusual nature of distribution of gas in intestines is visible; the barium enema confirms the abnormal provision of a caecum. At acute impassability the diagnosis is made during an urgent laparotomy; the only additional research — the survey roentgenogram at vertical position of the patient allowing to see levels of liquid and gas.
At a laparotomy eliminate torsion of guts, dissect the tyazh pressing a duodenum, straighten a large intestine and fix in the left half of an abdominal cavity, and a small bowel — in right. After operation carry out active therapy to warn shock and to recover water-salt balance.



 
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