小肠疾病英文教学文案.ppt

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1、小肠疾病英文Bloodsupplytothejejunoileumanddistalduodenumisentirelyfromthesuperiormesentericartery,whichcoursesanteriortothethirdportionoftheduodenum.Theceliacarterysuppliestheproximalduodenum.PhysiologyMotility:Peristalsisconsistsofintestinalcontractionspassingaborallyatarateof1to2cm/secco

2、ntractionsinitiatedbythemigratingmyoelectriccomplex(MMC)underthecontrolofbothneuralandhumoralpathwaysENDOCRINEFUNCTIONObstructionEtiology:Commoncausesofsmallbowelobstructioninindustrializedcountries:ClinicalManifestationsandDiagnosisCardinalsymptoms:colickyabdominalpainnauseavomiting

3、abdominaldistentionfailuretopassflatusandfecesPhysicalExamdistendedabdomenperistalticwavesminimalornobowelsoundsMildabdominaltendernesswith/withoutapalpablemassExamtoruleoutincarceratedherniasRectalexamRadiologicandLaboratoryExaminationsPlainabdominalradiographs:accuracy≈60%-dilatedl

4、oopsofsmallintestinewithoutevidenceofcolonicdistention-multipleair-fluidlevels,ofteninastepwisepattern-demonstratethecauseoftheobstructionCT:formorecomplexcasesPlainabdominalfilmshowscompletebowelobstructioncausedbyalargeradiopaquegallstone(arrow)obstructingthedistalileum.CTscanofthe

5、abdomenofapatientwithamechanicalbowelobstructionsecondarytoanabscessintherightlowerquadrant(arrow).Multipledilatedandfluid-filledloopsofsmallbowelarenoted.SimpleVsStrangulatingObstruction“Classic”signsofstrangulation:-tachycardia-fever-Leukocytosis-aconstant,noncrampingabdominalpainD

6、ifferentiationofpartialfromcompleteSBOPartialSBO:passflatusorliquidstoolsCompleteSBO:obstipationDifferentiationofProximal/distalSBOpain:epigastric/periumbilicalareavomiting:prominent/lateronsetdistention:no/predominateTreatmentMedicalandsurgicalmanagementTheoverlappingsequence:invest

7、igationresuscitationoperationThetimingofoperationdependsonthreefactors:-duration-opportunityofvitalorganfunction-riskofstrangulationMedicalManagementNasointestinal/nasogastricintubationIntravenousfluids/bloodplasmaadministrationBroad-spectrumantibioticsadministrationSurgicalprinciple

8、sThenatureof