RESUMO
The results of examination and treatment of 211 patients with late adhesive ileus (LTAI) are discussed. Highly sensitive noninvasive method of phonoenterography was used for LTAI diagnosis and control of the efficacy of non-operative treatment. The gastrointestinal motor-evacuation disorders were studied in a group of patients with chronic recurring LTAI. For revealing hypertension in the upper parts of the gastrointestinal tract, a special catheter is suggested by means of which the pressure in the gastric and duodenal cavities can be measured simultaneously. The suggested examination methods allowed a differentiated approach to the choice of the therapeutic tactics, objective control over the efficacy of the treatment, and substantiation of the indications for planned operative treatment of patients with a recurrent course of LTAI.
Assuntos
Obstrução Intestinal/complicações , Adolescente , Criança , Pré-Escolar , Doença Crônica , Terapia Combinada , Gastroenteropatias/etiologia , Gastroenteropatias/fisiopatologia , Motilidade Gastrointestinal , Humanos , Lactente , Obstrução Intestinal/fisiopatologia , Obstrução Intestinal/terapia , Recidiva , Fatores de Tempo , Aderências Teciduais , Resultado do TratamentoRESUMO
Clinical data (110 observations over 106 cases) and experiments on animals proved the inexpediency of the peritonization of non-pertonized surfaces in children both in "pure" peritoneum and under the condition of a pronounced inflammation. Renouncement of peritonization of peritoneal defects has favoured the decrease of the incidence rate of the recurrence of ileum and the improvement of late results of the treatment. The authors believed that the peritonization is needed only when defects of the intestinal wall reach the submucous level and as this takes place a pronounced bleeding, which cannot be controlled without suturing, is noted. Intestinal perforation localized in the non-peritonized sites was never observed, even when the muscular layer of the intestinal wall was damaged.
Assuntos
Peritônio/transplante , Cicatrização , Animais , Criança , Cães , Humanos , Obstrução Intestinal/cirurgia , Doenças Peritoneais/cirurgia , Recidiva , Membrana Serosa/cirurgia , Técnicas de Sutura , Aderências TeciduaisRESUMO
74 case histories of 63 children aged 10 to 14 were studied. They were subject to 95 operations. The Bartlett's method of operation was used in all the cases as least traumatic and most simple. Good results obtained in 93 children (97,2%) out of 95 enable the operation by Bartlett's method to be recommended to treat ingrowing toenails in children.