الالتصاقات البريتوانية ما بعد الجراحة على البطن
Abstract
أكدت معظم الدراسات على ارتفاع نسبة حدوث الالتصاقات البطنية في مرحلة ما بعد الجراحة خلال الأربعين سنة الماضية ، وهذا ما أكدته دراستنا أيضاً على عدد كبير من المرضى /561/ مريض خلال /10/ سنوات ، حيث تبين أن:
- الالتصاقات البطنية قد تتشكل بعد أسبوع واحد فقط أو خلال /50/ عاماً من بدء إجراء الجراحة على البطن خاصة جراحة الزائدة والجراحات النسائية ... ، حيث يلعب الفيبرين الدور الرئيسي في تشكلها ، كما صنفت هذه الالتصاقات في أربع درجات.
- المتلازمات والأعراض والعلامات السريرية تراوحت ما بين الألم البطني إلى اضطراب وظيفة أعضاء البطن إلى الانسداد المعوي بجميع أشكاله وتظاهراته المرضية.
- تشخيص هذه الحالات اعتمد بشكل أساسي على التظاهرات المرضية والفحص السريري بالإضافة إلى التصوير الشعاعي البسيط والملون وتخطيط الصدى وتنظير البطن الاستقصائي. كما أن المعالجة الجراحية كانت ناجعة عند الغالبية العظمى من المرضى.
- الوقاية ممكنة باتباع التدابير والإجراءات الجراحية بكل حذر واهتمام بالإضافة لقيام المريض بإجراء عدة تمارين رياضية محددة بعد تخرجه من المستشفى.
Most studies carried out during the last forty years assured an increase in the incidence of abdominal adhesions in the postoperative period.
This data has been confirmed by our study on a large number of patients /561/patients, in ten years time, our study showed that:
- Abdominal adhesions may appear after just one week or within fifty years from conducting abdominal surgery especially after appendectomy and gynecological surgeries, where the fibrin plays a major rule in their formation, these adhesions have been classified in four categories.
- Clinical symptoms, sings and syndromes fluctuated between abdominal pain, dysfunction of the abdominal viscerae and intestinal obstruction with all its forms and manifestations.
- The diagnosis of these cases depended primarily on the clinical presentations and clinical examination in addition to the plain and colored roentgenography, echography, laparoscopy and investigational laparotomy.
- Surgical treatment was curative in the majority of patients.
- Prophylaxis can be obtained by a careful and adequate conduct of the surgical management and procedures besides instructing the patient to do certain physical exercises after he leaves the hospital.
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