Emergency surgery of the abdominal cavity organs

Emergency abdominal surgery is one of the most urgent, responsible and complex areas in surgery. Patients with a so-called "acute abdomen" - the main contingent entering the hospital for emergency indications. Urgent operations with mandatory opening of the abdominal cavity are used for severe injuries, diseases and accidental injuries of the stomach, spleen, intestines, liver and abdominal wall defects( with hernias).

Emergency surgery for hernia

Hernias is a protrusion of any of the internal organs covered by the peritoneum, through the opening in the tendon and the muscular part under the skin. If this protrusion is formed in the inguinal region - it is inguinal hernia, at the navel - umbilical, on the femur in the area of ​​large vessels - femoral. Usually a sharp protrusion of the hernial sac is a consequence of an increase in intra-abdominal pressure: coughing, lifting the weight, straining.

When the organ is infringed within the hernial opening, a hampered hernia is formed, very dangerous, requiring urgent intervention by surgeons. It can lead to complete necrosis( necrosis) of the organ or to acute peritonitis - inflammation of the abdominal cavity. Non-surgical treatment of this kind of hernia rarely gives an apparent effect, sooner or later it is necessary to resort to surgery. And, with the onset of an attack, you need to operate already in an emergency.

There are only two types of operations for a hernia of the abdomen - hernioplasty with additional tension or without tension of the tissues. In the first case, the closure of defects in the abdominal wall is carried out by suturing the margins of the hernial gates. In the non-tight technique, the defect is eliminated by sewing an artificial "patch" in the hernia gates. The greatest distribution in the quality of such "patches" has recently been mesh polypropylene implants. The operation is performed under local anesthesia or spinal anesthesia.

Peptic ulcer of the stomach and duodenum

The disease is associated with a defect in the mucosa or deeper tissues of these organs. Her risk is that there is a danger of heavy bleeding with a breakthrough inside the abdominal cavity( perforation) or a rapid degeneration into a malignant tumor. In this case, the stomach is removed partially or completely, and a connection between the duodenum and the esophagus is additionally provided.

The most common type of surgery for a stomach ulcer is vagotomy. It is also applicable for ulcer of the duodenum. The essence of vagotomy is that during the operation the stomach remains intact. Only the nerve endings that are responsible for the production of gastrin are cut, which gives the effect of rapid healing of peptic ulcer in the digestive organs. There is also an operation for resection of the stomach. During this operation, the ulcer itself and part of the stomach that produces hydrochloric acid are removed. Due to this, new ulcers are not formed.

Surgery in appendicitis and cholecystitis

Appendicitis is a condition in which the vermicular appendix of the cecum is inflamed. Its course can be both acute and chronic. In the operation( appendectomy), the inflamed vermiform appendix is ​​removed. The operation is performed under local anesthesia or under general anesthesia. The latter is especially often used in the complicated form of appendicitis. After opening the abdominal cavity, the surgeon finds a vermiform appendage with a base near the junction of muscle bands. The appendix with the part of the cecum is mobilized, by dissecting its mesentery. Afterwards, the catgut ligature is applied to the base of the process, above which it is cut off. The remainder of the appendix is ​​immersed in the z-shaped and pouchy sutures. The toilet of the abdominal cavity is produced, the wound is sewed tightly or drained.

Immediate surgical intervention is also used for acute cholecystitis. The disease is an inflammation of the gallbladder. It must be remembered that in a poorly examined and unprepared patient, an urgent operation associated with acute cholecystitis is a dangerous intervention. It is often safer to postpone it altogether. After stihaniya attack cholecystitis patient must be thoroughly examined. With the confirmation of the diagnosis and the absence of contraindications, surgical treatment can be prescribed. Emergency surgery for cholecystitis is carried out with direct danger for the life of the patient.