Adhesive intestinal obstruction constitutes a violation of the content passage gastrointestinal tract due to the presence of scar adhesions in the peritoneum. Mostly, this pathology is a consequence of surgical intervention in the abdominal cavity. However, this type of obstruction is also provoked by other factors.
The following clinical picture is characteristic of intestinal obstruction: cramping severe pain, intoxication, vomiting, dizziness, asymmetrical bloating, as well as the inability to stool and pass gas. Diagnose pathology digestive system possible using MRI, ultrasound, x-ray and CT. Treatment tactics depend on the form of pathology and other characteristics of the disease. In some cases, repeat surgery is required.
Adhesive intestinal obstruction is accompanied by a violation of passage food bolus, as well as digestive juices through the intestines. Prevent this adhesion process. Pathology is a common problem arising in gastroenterology and surgery. It accounts for about 40% of all cases of intestinal obstruction. This type of disease equally affects men and women of all ages.
There are a number of factors that contribute to the development of adhesive intestinal obstruction. This may be bleeding in abdominal cavity, presence of damage, foreign body or purulent processes in the peritoneum. Obstruction can also be caused by ischemic disease gastrointestinal tract, surgical intervention, causing dryness of the abdominal cavity. In some cases, there is a genetic predisposition.
The formation of adhesions is observed against the background of a disorder of certain processes related to the resorption of inflammatory components, as well as their replacement by tissue. In case of injury, the peritoneum begins to synthesize exudate, which has an adhesive structure. Based on its cells, fibers are formed. Fibrin then falls out, which should be absorbed after healing. If this does not happen, adhesions form.
Adhesive type obstruction has three types: combined, obstructive, strangulation. There are chronic, acute and hyperacute forms of this pathology. The hyperacute type of the disease is characterized by lightning speed of development and intense manifestation symptoms.
The obstructive type of intestinal obstruction is provoked by strong compression of the intestinal loops by adhesions. This process does not disrupt innervation or blood supply. The pain syndrome appears suddenly. It is directly related to peristalsis; paroxysmal character predominates. The vomit may contain greens or bile, depending on the level of obstruction. Symptoms: uniform bloating, constipation and lack of passing gas.
Strangulation obstruction occurs due to compression of the mesentery. May be complicated by necrosis of the gastrointestinal tract. Symptoms of pathology gain strength instantly, acutely. There are cramping intense pain in the abdomen. The pain syndrome has no clear localization. Symptoms are accompanied by pallor skin, lack of appetite. If necrosis develops, the symptoms subside for a while. If such a clinical picture call an ambulance.
As for vomiting, there are no impurities in it. It is reflexive in nature. The cause of vomiting is injury to the mesentery. Symptoms of toxicosis quickly appear and intensify: weakness, dehydration, dizziness, horse racing blood pressure, increased heart rate, etc. The pain increases the tension of the abdominal muscles, so it becomes hard. Noted increased peristalsis organ.
If the cause of obstruction is abdominal surgery, the pathology may appear even after several weeks. In this case, the following clinical picture is observed:
If the pathology began to develop after a long period time after surgery, late intestinal obstruction is recorded. This type of disease is characterized by cramping frequent pain, vomiting, lack of gas and stool. Intoxication of the body rapidly increases.
Intestinal obstruction is suspected based on the existing clinical picture. The main method diagnostic study An X-ray of the abdominal cavity using barium is considered. This study helps to identify distension of intestinal loops. Ultrasound, MRI, CT, and laparoscopy are used to determine an accurate diagnosis.
Therapeutic manipulations are prescribed by the attending physician based on the following data: type and stage of pathology, period of its development, concomitant pathologies. If the stage of the disease is early, therapy begins conservative methods. Doctors normalize the functioning of the gastrointestinal tract. In many cases, such therapy serves as a measure of preoperative preparation of the patient. Must be picked up optimal duration similar treatment to complete the operation on time.
When found primary symptoms patients are prescribed intravenous nutrition, and measures are prescribed to help improve intestinal motility. Such measures prevent intoxication and also improve general state sick.
If signs of pathology appear on the third day after surgery, it is necessary to neutralize the paretic part of the obstruction. To do this, Trimecaine is injected into the epidural space. In parallel with these actions, the stomach is washed, an enema is given, and Proserin, a solution of Sodium Chloride, is administered intravenously. If there is no positive dynamics within six hours, a laparotomy is performed.
In case of suspicion of a strangulation form of adhesive obstruction, it is allowed to adhere to a short-term conservative treatment. After this, an operation is performed and post-operative care for the patient. As for the late stage of the disease, surgical intervention is urgently indicated. Without proper treatment, there is a risk.
Before you start surgical intervention, it is important to properly prepare the patient. First of all, a siphon enema is given, the stomach is thoroughly washed, and Prozerin is administered. If after a few hours the pain subsides and the symptoms fade away, anti-adhesion therapy and inpatient treatment are prescribed. If there is no improvement in the condition, laparotomy is indicated to separate the adhesions, establish an anastomosis, or perform resection. When the patient is brought to medical institution V in serious condition, he is prescribed intensive care to eliminate intoxication of the body and perform surgery.
Adhesive obstruction – dangerous disease, requiring urgent treatment. If symptoms occur, you should immediately seek medical help.
Intestinal obstruction is pathological condition organism, in which there is a violation of the passage of food debris and gastric juices towards the patient’s colon. If you ignore the clinical picture of the disease, untimely detection or self-medication, the disease can acquire more impressive dimensions, causing significant harm to the human body.
Adhesions are cords formed from parts of connective tissue, resulting in fusion and displacement internal organs patient. The main reason for the appearance of adhesions in the body is a damaging factor. Due to accidental mechanical injury, infectious disease, presence large quantity accumulated blood clots or foreign bodies, and also due to the influence of various chemical substances The connective tissue begins to grow, leading to the formation of small processes. In most patients (5-20%), adhesions occur as a result of previous operations. In this case, the disease may appear either immediately after surgery or several years after it. There is also a separate category of patients who have a predisposition to the occurrence of adhesions in the form of an excess of certain enzymes. Such enzymes make themselves felt in cases of even the smallest and most insignificant injuries.
Adhesions are a protracted and rather serious illness. Ignoring their existence by the patient can lead to the formation of an acute form of adhesive intestinal obstruction. IN in this case the patient experiences a disturbance in the passage of the contents of the gastrointestinal tract, microcirculation and inflammation of the abdominal cavity develop.
Adhesive intestinal obstruction is usually divided into two main groups: and mechanical. The main cause of dynamic obstruction in patients of different age categories is the resulting spasm (paralysis) of the intestines. Such a spasm can be triggered by anything: poisoning with chemical or toxic substances, previously suffered from severe infectious diseases etc. Mechanical adhesive intestinal obstruction is a disease that occurs in more than 80% of patients. In addition to the presence of a large number of adhesions in the body, the disease can be caused by strangulation of some part of the intestine due to a hernia, as well as volvulus, the presence of worms or gallstones.
The first and main symptom that can be used to diagnose adhesive obstruction in the intestine is pain. Depending on the severity and extent of the disease, the pain can be either sharp and intense or moderately weak and regularly recurring. The patient's attacks of pain may subside and return again. In addition, the patient feels unpleasant bloating abdomen, strong and weak urination. In the early stages of the disease, vomiting with an unpleasant yellow-green mixture may occur. The nature and amount of vomit depends on the stage of the disease. With progressive intestinal obstruction, the patient begins to experience breath holding, cardiovascular spasms, the temperature rises and tachycardia begins.
A qualified specialist can diagnose intestinal obstruction both during palpation and through a thorough examination and questioning of the patient. If adhesions are detected in the body important role any information about the character plays pain. The patient donates blood for laboratory analysis, and also undergoes radiography of all organs of the abdominal region. A more detailed examination includes ultrasound and computed tomography, which makes it possible to more accurately identify the root cause of the disease, make a diagnosis, and prescribe correct and effective treatment.
In the presence of early stage For diseases, therapeutic procedures begin with complex conservative treatment. Most challenging task The doctor is to determine the timing of conservative treatment and (if they are ineffective) - to choose the most rational method of surgical intervention. The preoperative period includes feeding the patient through the mouth with special nutritional mixtures, as well as a set of measures that have an enhanced effect on colon peristalsis and reduce dehydration. If there is a late stage of obstruction, urgent preoperative preparation. Doctors prescribe gastric lavage, enema and bilateral renal blockade with novocaine to the patient.
Surgery is a resection intestinal region, separation of adhesions and bypass anastomosis of both the afferent and efferent loops of the intestines. Also very popular in Lately is Noble's operation, during which specialists carry out complete or partial separation of the loops, eliminate existing adhesions and place parts small intestine next to a friend, sewing and firmly fixing them in this position. After the operation, the patient continues to receive blood substitutes intravenously and saline solutions, do antibacterial and anti-inflammatory therapy, and also stimulate motor function guts everyone accessible ways. In the first few days the patient is assigned bed rest and a healthy diet. He can eat and drink only with the permission of a doctor. During the first month the patient remains on dispensary observation, undergoes a variety of rehabilitation and physiotherapeutic procedures.
Of particular importance in the treatment of adhesive intestinal obstruction is correct 
prepared diet. The main recommendations for maintaining a gentle diet come down to the minimum amount of food consumed. The patient should not overeat and overload his body. Food should be fractional, it should be taken in small portions every 2-3 hours. The maximum volume of liquid is 1.5 liters per day.
The basis of the diet is to take low-fat meat or vegetable broths, warm decoctions and dishes that have a ground or pureed appearance. It is allowed to eat porridge with water, various egg and curd soufflés, compotes and decoctions. It is necessary to exclude carbonated water, milk, kefir, as well as products with a dense consistency from the menu.
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The functioning of the digestive system plays an important role in the life of every person. Various types of disturbances occurring in this area cause discomfort to people and significantly worsen the quality of life. The most common digestive tract disorder is diarrhea. Much more dangerous and quite rare disease- adhesive intestinal obstruction. Every person who is concerned about their own health needs to have an idea of how pathology manifests itself and is diagnosed.
From the name of the disease “adhesive intestinal obstruction,” it can be assumed that this deviation is the formation of adhesions in the abdominal cavity, which cause difficulty in passing feces. In scientific terms, the pathology is a violation of passage through the intestines. Obstruction can be mechanical or dynamic: 
The adhesions that appear in the intestines are so-called cords. They can glue loops together (horizontally or vertically), and also attach the digestive tract to abdominal wall. Much less often, adhesions tighten the intestines with other organs located nearby.
Adhesive intestinal obstruction can be divided into types. Each of them has distinctive features.
According to the nature of the disease, it is divided into chronic and acute. IN the latter case the symptoms are more pronounced, and the disease is easier to diagnose. Also, adhesions formed in loops can have the following forms:
It is important to know about the symptoms of the disease. Often people have no idea about the existing pathology and self-medicate. Such a negligent attitude towards one’s own health is fraught various kinds troubles.
Depending on the type and stage of the disease, as well as associated factors and the general well-being of the patient may manifest different symptoms. Absolutely all types of intestinal obstruction are accompanied by painful sensations . Women who have had the opportunity to give birth to children compare this condition with contractions. During a spasm of smooth muscles, the pain increases, and when relaxed, it decreases. The patient may talk about unpleasant sensations and indicate where they occur (locally). But much more often the pain spreads throughout the entire peritoneum. In addition, the disease is manifested by the following symptoms:
Timely correct positioning diagnosis and assistance provided are the key to a favorable outcome.
Despite all the recommendations, many patients try to independently determine the cause of abdominal pain. They are guided by different reasons: some don’t have enough time, others are afraid. How to determine at home that adhesive obstruction has occurred? Pay attention to the following indicators.
Doctors use to make a diagnosis different methods: palpation, ultrasound, x-ray, use of contrast medium, laparoscopy. Anamnesis must be taken into account and a survey is carried out, since one of common reasons the formation of adhesions is a previous surgical intervention.
Treatment of intestinal obstruction at home very often begins with the wrong actions. It is important to remember what you should not do if the signs are described: 
Before using any other medication, be sure to read the instructions. If intestinal obstruction is indicated in the contraindications column, then taking medications is not only useless, but also dangerous.
Gastrointestinal colic caused by the formation of adhesions can sometimes be treated at home. It is important to remember the basic rule: if it hasn’t gotten better for several hours, and the pain is only getting worse, then you need to call Ambulance or go to the nearest hospital as an emergency.
In case of incomplete or partial intestinal obstruction, it is permissible to use plant decoctions. Anti-inflammatory drugs that soothe and indirectly reduce pain are ideal. You can brew: 
To do this, pour a glass of boiling water over a spoonful of dry herbs and leave until it cools. The decoction is taken warm during the day. At increased gas formation intestines, you can use a decoction of fennel or dill seeds (the method of preparation is the same).
In order for gases to leave the intestines faster, you need to take a knee-elbow position. The head should be placed as low as possible. The back should form an angle with the surface on which the patient is located. The bigger it is, the better. Being in this position provokes the rise of gases and their unhindered exit.
Important: this method only works for incomplete intestinal obstruction.
When there is an intestinal blockage, meals should be minimal and fractional. It is not recommended to eat hard and solid foods. Bran, which is so beneficial for human body, are strictly prohibited. Any food that is not digested can cause serious harm.
Preference should be given to soft foods: broths, pureed soups, pureed masses. Vegetables and fruits must be tested before consumption. heat treatment. Prohibited dairy products, fatty meats, smoked meats, alcohol and carbonated drinks. You need to eat in small doses every 2-3 hours.
In newborn babies and children under the age of one year (usually 4-7 months), a pathology called “intussusception” may occur. This condition is characterized by the fact that one loop can seem to penetrate into another. As a result, the intestines become blocked. Signs this state the following: 
This pathology most often occurs in children with overweight. If you consult a doctor in time and receive qualified help, the prognosis will be favorable. Treatment for intussusception of intestinal loops involves straightening them. The procedure involves pumping the excretory system with air, but this method is effective only for 12-18 hours after the event. In other situations, surgical intervention is performed.
Intestinal obstruction is very serious pathology, which can lead to fatal outcome. Doctors have several treatment tactics. The choice will depend on the clinical picture and type of obstruction, the number of adhesions. Hospitalization is carried out in 95% of cases when this diagnosis is confirmed.
Laparoscopy is widely used in the treatment of pathology. The operation allows you to separate the loops and remove adhesions without unpleasant consequences.
Adhesive intestinal obstruction- a pathology that usually occurs as a result of surgery. Adhesions form in the abdominal cavity. Symptoms are expressed by vivid manifestations - the person experiences severe discomfort and pain. The first signs of intoxication appear.
Adhesions occur in the intestines in response to severe inflammation, injury or postoperative period. Digested food cannot move forward, which is accompanied by chronic constipation. Intoxication develops.
Among this type of pathology, it is very common - it is not affected by the age or gender of the patient. You can only get rid of adhesions surgical method. complex and requires special vigilance. Talcum powder should not be allowed to enter the abdominal cavity. Tissue union occurs within 5-7 days.
Adhesive intestinal obstruction is divided into several types:
The first type of pathology develops against the background of intestinal immobility. Long-term condition rest leads to the fact that the intestinal loops begin to stick together.
The food does not move forward, which causes severe symptoms. The process of resorption of adhesions begins after a week. The body overcomes this problem on its own.
The development of pathology is influenced by several factors:
The mechanism of development of adhesive formations can be explained by the resorption of inflammation. The elements that provoke it are replaced connective tissue. The peritoneum tends to produce an adhesive substance as a protective reaction.
Fibrin is part of connective fibers. When complete healing occurs, it must dissolve on its own, otherwise it acquires the structure of elastic fibers. This is how adhesive intestinal obstruction occurs.
The pathology has acute, critical, and chronic forms. Each is determined characteristic symptoms. The development of the clinical picture is determined by the type of disease and signs of its development.
The development of pathology a month or more after surgery confirms the adhesive sign of a late stage. The patient suffers from sharp and sudden pain and vomiting.
The act of defecation and gas removal is not carried out independently. Intoxication develops quickly. A person suffers from general malaise, fatigue, weakness, dizziness.
Adhesive intestinal obstruction may have symptoms chronic stage. This form of pathology is defined as abdominal adhesive disease. The risk group includes women who are childhood faced with an appendectomy. Arises due to the characteristics female body, because the oviduct and the ovaries are located close to the intestines.
The occurrence of adhesions is accompanied by repeated signs of intestinal obstruction. Manifested by the following factors:
In some cases, this form of pathology can be cured using conservative methods. Enemas will help effectively, as they do not empty the intestines. Its function is restored, pain disappears, and general condition improves.
Adhesive intestinal obstruction can be diagnosed using several examinations. Initially, the doctor conducts visual inspection patient, studying anamnesis. Using the palpation method, he studies the reaction in the abdominal cavity, after which he prescribes additional examination. The main methods include:
Treatment is carried out by a gastroenterologist or surgeon. If adhesions have formed after surgery, the same doctor can treat them.
Surgeons often encounter adhesive intestinal obstruction in patients. After undergoing the simplest operation - removal of appendicitis, a person may suffer from various complications. Especially from the formation of adhesions, which occur very often. Acute form intestinal obstruction poses a threat to the patient's life. In such cases, surgery is required.
Two types of surgery are used: wide dissection and endoscopy. The latter method can only be used if the patient has no contraindications. These include:
If the victim has contraindications to endoscopy, the operation is performed with a wide opening of the abdomen.
Adhesive intestinal obstruction largely depends on the doctor who performs the operation. He must behave carefully during the procedure, avoid drying out the peritoneum, and limit the administration of dry preparations. It is important to promptly remove blood and foreign objects.
In the postoperative period, the patient should be prescribed physical therapy. Effective is: UHF, electrophoresis. The patient must lead an active lifestyle, exercise physical therapy. Adhesions mainly occur when the abdominal cavity is immobilized; such procedures will help prevent recurrence of obstruction.
The diet for intestinal obstruction is responsible for digestion and stool formation. List of allowed dishes and products:
Dietary nutrition is prescribed by the doctor in the postoperative period. If the patient is in a hospital, he is offered special hospital meals. In addition, it is prohibited to eat certain components. The following foods should be excluded from the diet:
The patient must chew food thoroughly. It is better to divide the meal into 5 meals a day. You cannot eat cold or hot food, it must be warm. It is recommended to eat soft foods and purees.
Intestinal obstruction is a serious pathology. A person suffers from chronic constipation, digestive disorders. In addition to medication and surgical treatment, great importance has proper nutrition and an active lifestyle.
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