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Motive frustration. a stomach and 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
MOTIVE FRUSTRATION

This group is made by the frustration of an unknown etiology conducting to functional, a thicket chronic, impassability of intestines. Treatment them, as a rule, does not yield satisfactory results.

Chronic impassability of a duodenum, syndrome of an upper mesenteric artery

This state is shown by periodic functional impassability. One authors explain with its prelum to the lower third of a duodenum between an upper mesenteric artery and an aorta. Others consider it as a result of loss of fatty tissue which usually supports average and lower thirds of a duodenum, and gut prelums - a lumbar lordosis. In certain cases chronic duodenal impassability results from incomplete turn of intestines.
Among patients teenage girls, high, harmonous, an asthenic constitution, with a visceroptosis prevail. In the anamnesis "bilious gripes" or other forms of incidental vomitings are noted. Radiological also the fast oscillating peristaltic motions come to light megaduodenum. Expansion of a duodenum sharply is interrupted at the average line of a stomach. The stomach can be also sharply expanded. At suspicion on the wrong turn it is necessary to execute an irrigoskopiya to define the provision of a caecum.
If it is possible to improve food of the patient, to remove irritation of a duodenum, then impassability, as a rule. it is liquidated. The simplest method of treatment consists that after food of the patient adopts the genucubital provision thanks to what the duodenum departs from the squeezing, its retroperitoneal structures. Feeding through the catheter entered into a jejunum, or exclusively parenteral food within several weeks snosobstvut to growth of a paraduodenal fatty tissue that strengthens the supporting device of a gut and promotes straightening of a duodenoyeyunalny bend. There are these literatures that Metoclopramidum (cerucal) has positive effect at this state. If prolonged conservative treatment does not yield result, then surgical intervention can be required. Operation of the choice is Ledd's technique; less satisfactory effect is noted after a duodenojejunostomy.

Pseudo-impassability

Because the survival of children with the split stomach increased, cases of pseudo-impassability of intestines are even more often observed. At such children the innervation is not broken, but in response to stretching there is no descending peristaltic wave in intestines. Treatment consists in creation of absolute rest for a digestive tract for what the patient is transferred to parenteral food. For the prevention of inflating of a stomach the air swallowed during food sometimes it is necessary to impose a gastrostomy. Motive disorders of a gullet reveal by means of manometrical researches.
In literature at least 15 cases of inborn segmented expansion of a small or large intestine are described. The local short site of a small bowel is expanded and is not capable to move intestinal contents to adjacent distal part of a gut. Innervation of an expanded segment normal. This state can cause acute impassability in newborns or chronic impassability with considerable; expansion of a small bowel at children of advanced age. Good results are yielded by a resection of an expanded loop of intestines.
Also pseudo-impassability of a large intestine at which X-ray contrast research with a baric suspension or Gastrografinum reveals an atony site is known. Treatment by parasympathomimetic means inefficiently.
Other type of pseudo-impassability of a large intestine is characterized by considerable expansion of a gut, as at an illness of Girshprunga; the quantity of ganglionic cells at this state is not reduced. If the kolostoma yields a positive take, then it is reasonable to resect the struck segment. At children whose mothers are sick with diabetes symptoms of the intestinal impassability of the newborn known under the name "syndrome of an underdevelopment of the left half of a large intestine" can be observed; on roentgenograms signs of the expressed megacolon with clearly distinguishable aganglionarny segment extending to a splenic bend and even above are visible. The tone of a proctal sphincter and these researches of a bioptat of a rectum meet standard. This state usually does not demand special treatment.



 
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