Survey
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Department of the faculty and hospital surgery of the medical faculty of the Tashkent medical academy Intestinal fistulas Prevalence of intestinal fistulas • Each surgeon has to observe patients with fistulas of the stomach and intestines, but such patients are uncommon. • Intestinal fistulas occur only 1-2% of all operations on the abdominal organs. • Development of surgery and critical care medicine, not only did not decrease, but rather increased the number of complications due to perform complex surgical procedures, reconstructive operations on the abdominal organs, including the elderly and debilitated patients. • Particular difficulties arise in the treatment of immature intestinal fistula, mortality in this case varies from 20 to 71.7%. Intestinal fistula II. Medical - artificial wormholes I. Congenital III. Abnormal intestinal fistulas Intestinal fistula - a message from the intestinal lumen surface of the body lumen or other hollow organ. Medical - artificial wormholes In order to decompress the intestine гастростома энтеростома колостома Medical - artificial wormholes In order to supply the patient Гастростома Энтеростома Питательные вещества Technical resources for feeding Roller Pumps Probes and catheters Reservoirs Medical - artificial wormholes One of the stages of surgical intervention Hartmann operation The causes of fistula after operation • • • • • • Acute appendicitis 49.3% Acute cholecystitis 14.8% Acute intestinal obstruction 12.3% Hernia strangulation 8.4% The trauma of the abdomen 8.7% Other diseases 6.5% The mechanism of development of intestinal fistula The continued presence of drainage tubes The failure of sutures intestinal fistula Neglect with the tissue during operations Capture intestine on sutures Intestinal fistulas Internal Moulded Through the cavity Thinly intestinal Outdoor Complete Moulmed Opening liping Thick intestinal Not complicated Moulded Кучимли Mixed Complicated Tubular Complex Varieties of immature (open) intestinal fistulae Moulded intestinal fistulas liping Tubular Complete and incomplete intestinal fistulas incomplete intestinal fistulas incomplete intestinal fistulas Complete intestinal fistulas Treatment Create optimal conditions for the formation of immature fistulas • Prevent the spread of intestinal contents into the abdominal cavity, to create conditions for the restriction of the process (the formation of intestinal fistula) • Create conditions for free outflow of intestinal contents • Decompression of the afferent loop • Active aspiration • Install drainage and other Treatment Compensate for the loss and prevent metabolic disease. • Return of the lost intestinal juice through the fistula • Infusion (electrolyte solutions, carbohydrates, amino acids, blood, plasma, vitamins, etc.) • Parenteral nutrition (Infezol, Selemin, Selepid) • Enteral nutrition through a tube Treatment Surgery, antibiotic therapy and anti-inflammatory • • • • • Broad-spectrum antibiotics, sulfonamides Restorative therapy Immunotherapy Prevent stagnation of intestinal contents in the fistula Prevention of inflammation of the skin around the wound (Lassara pasta, etc.) • During the attempted operation (elimination of intestinal fistula) Methods return a lost of intestinal contents into the intestine. Methods return a lost of intestinal contents into the intestine. Methods return a lost of intestinal contents into the intestine. Methods for elimination of intestinal fistulas Resection of the small intestine with fistulas course and entero-entero anastamoz Methods for elimination of intestinal fistulas Resection of the colon with fistulas course and enteroentero anastamoz Methods for elimination of intestinal fistulas. The wedge resection of enteral fistula Methods for elimination of intestinal fistulas Resection of the colon in place with a fistula Duties of the general practitioner in intestinal fistulas • • • • • • • • • • - Provision of primary health and social care; - Health education (promoting healthy lifestyles); - Preventive work (timely detection of early and latent forms of the disease, risk groups); - Dynamic monitoring; - Emergency assistance in case of emergency and acute conditions; - Timely consultation and hospitalization in the prescribed manner; - Medical and rehabilitation work in accordance with the qualifying characteristic; - An examination of temporary disability; - The organization of medical and social care and household together with the bodies of social protection and services of mercy alone, the elderly, the disabled, the chronically ill; - Maintaining the approved forms of records and reports.