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},
"code": "K44",
"name": "Диафрагмальная грыжа",
"icd_name": "Диафрагмальная грыжа",
"gender": 0,
"age_min": 0,
"age_max": 100,
"cause": [
3,
0
],
"periodicity": 1,
"slug": "k44_diafragmalnaya_gryzha",
"lead": "врожденная неправильность развития в виде анатомического дефекта в области прохождения через диафрагму органов, иногда значительное недоразвитие диафрагмы. Приобретенные грыжи возникают реже, при повреждениях диафрагмы",
"description": "",
"etiology": "<p>Недоразвитие мышечного слоя диафрагмы имеет своим следствием образование грыжевого мешка, выпяченного в грудную полость (истинная грыжа). Недоразвитие всех слоев диафрагмы приводит к появлению сквозных дефектов или ложной грыжи. Грыжевой мешок при ложных грыжах отсутствует, а органы брюшной полости, смещенные в грудную полость, непосредственно соприкасаются с легким. Образование грыжи пищеводного отверстия связано с замедлением темпов внутриутробного опускания желудка. Значительное число детей с диафрагмальными грыжами погибает в первые месяцы жизни. Различают грыжи собственно диафрагмы, грыжи пищеводного отверстия диафрагмы, грыжи переднего отдела диафрагмы.</p>",
"pathogenesis": "",
"diagnostics": "<p>Физикальные данные обычно неясные, окончательный диагноз ставится на основании УЗИ, рентгенографического исследования.</p>",
"treatment": "<p>Хирургическое при всех видах диафрагмальных грыж.</p>",
"prevention": "",
"clinical_picture": "<p>При грыжах собственно диафрагмы отмечаются приступы цианоза, <a href=\"/symptom/odyshka/\" title=\"Перейти на страницу симптома Одышка\">одышка</a>, <a href=\"/symptom/rvota/\" title=\"Перейти на страницу симптома Рвота\">рвота</a>, иногда <a href=\"/symptom/kashel/\" title=\"Перейти на страницу симптома Кашель\">кашель</a>, <a href=\"/symptom/ikota/\" title=\"Перейти на страницу симптома Икота\">икота</a> и т. д. Дети плохо развиваются, отстают в весе и росте. Грыжи пищеводного отверстия проявляются упорной рвотой, часто с примесью крови, анемией, явлениями эрозивно-язвенного гастрита, болями и урчанием в груди. Грыжи переднего отдела диафрагмы характеризуются деформацией грудной клетки в виде киля, болями в груди и животе.</p>",
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"parent": null,
"block_rubric": 113,
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},
{
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},
"code": "K43",
"name": "Грыжа передней брюшной стенки",
"icd_name": "Грыжа передней брюшной стенки",
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"lead": "выхождение внутренних органов через естественные либо приобретенные отверстия в мышечно-апоневротическом слое брюшины при сохранении целостности самой брюшины и кожного покрова",
"description": "",
"etiology": "<p>Грыжи возникают вследствие действия различных неблагоприятных факторов. Предрасполагающими факторами являются астеническое или гиперстеническое телосложение, резкое снижение или повышение массы тела, молодой или пожилой возраст, увеличение в объеме органов брюшной полости. Также образованию грыж способствуют травмы или атрофия мышц передней брюшной стенки, запоры и <a href=\"/symptom/meteorizm/\" title=\"Перейти на страницу симптома Метеоризм\">вздутие</a> живота, <a href=\"/symptom/kashel/\" title=\"Перейти на страницу симптома Кашель\">кашель</a>, затяжные роды, <a href=\"/symptom/ascit/\" title=\"Перейти на страницу симптома Асцит\">асцит</a>, беременность.</p>",
"pathogenesis": "<p>Составными частями грыжи являются грыжевые ворота, грыжевой мешок и грыжевое содержимое. В грыжевом мешке выделяют устье, шейку, тело, дно.</p>",
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"treatment": "<p>Требуется экстренная операция.</p>",
"prevention": "<p>Прежде всего, профилактика грыжи живота направлена на то, чтобы удалить главную причину возможного заболевания. В большинстве случаев основополагающим фактором её развития являются истощенные стенки живота. Стать слабыми они могут из-за преклонного возраста, травмы, проведенной операции или вследствие анатомического строения.</p>",
"clinical_picture": "<p>При ущемлении грыжи отмечаются внезапное возникновение боли в области грыжи, невправимость грыжи, увеличение в объеме и напряженности грыжи, ее болезненность при пальпации, внезапное исчезновение симптома кашлевого толчка.</p>",
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"etiology": "<p>Грыжи возникают вследствие дефекта анатомического строения пупочного кольца и действия факторов, которые вызывают повышение внутрибрюшного давления и растяжение передней брюшной стенки. Существует мнение о возможной роли наследственной предрасположенности в образовании пупочной грыжи у взрослых, что выражается в недоразвитии или отсутствии пупочной фасции, и это действительно выявляется во время операций. Однако пупочная фасция может разрушаться и вторично - из-за давления растущей грыжи. Причины, вызывающие повышение внутрибрюшного давления и растяжение брюшной стенки: беременность, ожирение, асцит различного происхождения, быстро растущие опухоли брюшной полости, упорные запоры. </p>\r\n<p>Образованию пупочной грыжи в детском возрасте способствует плач ребенка, постоянные запоры, газообразование в кишечнике, недоношенность. Иногда появление грыжи совпадает с началом хождения ребенка, особенно в тех случаях, когда он слишком рано принимает вертикальное положение. Склонность к образованию пупочной грыжи имеют дети с врожденным гипотиреозом, болезнью Дауна, болезнью Харлера, лактазной недостаточностью, дисбактериозом кишечника.</p>",
"pathogenesis": "<p>Пупочные грыжи формируются как результат дефекта развития передней брюшной стенки. Обычно самым слабым местом является верхний отдел пупочного кольца, через который проходит только пупочная вена, не имеющая мышечной оболочки. При недоразвитии брюшной фасции она прикрывает изнутри пупочное кольцо лишь частично, образуя дефекты, или же бывает слишком истончена и недостаточно прочна. При этом к возникновению грыжи могут привести все факторы, вызывающие резкое повышение внутрибрюшного давления.</p>\r\n<p> </p>",
"diagnostics": "<p>Диагноз ставится на основании клиники. К дополнительным методам исследования относят:</p>\r\n<ol>\r\n<li>УЗИ – позволяет выявить при больших грыжах содержимое грыжевого мешка и провести дифференциальную диагностику.</li>\r\n<li>Рентгеноконтрастное исследование и обзорная рентгенография практически не используются при неущемленных грыжах у детей, но могут быть применены при диагностических затруднениях у взрослых. Диагностически значимыми считаются обнаружение петель кишечника в проекции грыжевого мешка, нарушение пассажа контраста. </li>\r\n</ol>",
"treatment": "<p>У детей пупочная грыжа может спонтанно регрессировать, что связано с физиологическим укреплением мышц живота. Поэтому до 5-летнего возраста показано наблюдение за пупочной грыжей. В этот период рекомендуется выкладывание детей на животик, назначается тонизирующий массаж передней брюшной стенки, общий массаж, ЛФК, наложение лечебной лейкопластырной повязки на пупок.</p>\r\n<p>Взрослым и детям старше 5 лет с нерегрессировавшей пупочной грыжей показано хирургическое лечение (герниопластика). При пупочной грыже применяются два типа операций – герниопластика местными тканями и с использованием сетчатых имплантов.</p>",
"prevention": "<p> </p>\r\n<p>Мерами профилактики пупочной грыжи служат: предупреждение ситуаций, связанных с натуживанием грудного ребенка (надсадного крика и плача, вздутия живота, запоров и пр.), рациональное кормление, профилактический массаж и гимнастика, направленные на укрепление брюшной стенки, лечение дисбактериоза кишечника, ношение беременными дородового бандажа.</p>\r\n<p> </p>",
"clinical_picture": "<p>Пупочные грыжи у детей В вертикальном положении ребенка и при натуживании в области пупка появляется грыжевое выпячивание округлой или овальной формы, которое, как правило, вправляется самостоятельно при смене положения ребенка в горизонтальное на спине. В этом случае легко пальпируется расширенное пупочное кольцо, являющееся грыжевыми воротами. Ворота могут быть широкими - грыжа легко выходит и вправляется в брюшную полость, не причиняя ребенку никаких беспокойств и не травмируя внутренние органы. Если же грыжевые ворота узкие, ребенок периодически ведет себя беспокойно, плачет. </p>\r\n<p>Пупочные грыжи у взрослых Клинические проявления зависят от следующих факторов:</p>\r\n<p>- величина грыжи;</p>\r\n<p>- размеры грыжевых ворот;</p>\r\n<p>- выраженность спаечного процесса;</p>\r\n<p>- наличие или отсутствие осложнений;</p>\r\n<p>- сопутствующее ожирение. </p>\r\n<p>Размеры грыжи могут варьироваться от 1-2 см в диаметре до 20-30 см и более. Однако даже при очень больших грыжах грыжевые ворота достаточно малы и редко достигают в диаметре более 10 см.</p>\r\n<p>Небольшие пупочные грыжи (при условии, что они вправимы и не ущемлены) не причиняют больным значительных беспокойств. В том случае, когда содержимым грыжи является фиксированный в грыжевых воротах участок большого сальника, который как бы полностью тампонирует грыжу, она протекает бессимптомно и не увеличивается в размерах. Более часто, вследствие узости ворот, выхождение грыжи сопровождается болями, которые могут также зависеть от натяжения большого сальника, припаянного к стенкам грыжевого мешка. </p>\r\n<p>Большие грыжи при относительно узких воротах затрудняют проход содержимого по кишечнику. Типичные проявления: запоры, метеоризм, периодически появляющиеся боли в области грыжи, тошнота, рвота. Особенно сильно выражены эти явления при невправимых грыжах. Состояние пациентов может отягощаться тучностью и отвислым животом, что в сочетании с грыжей причиняет им значительные неудобства при ходьбе, физической нагрузке и сопровождается болями в спине.</p>\r\n<p>Когда больной находится в вертикальном положении и при натуживании в пупочной области появляется характерное выпячивание. Часто через истонченную кожу отчетливо видны контуры кишечных петель и их перистальтика. </p>\r\n<p> </p>",
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},
"code": "K41",
"name": "Бедренная грыжа",
"icd_name": "Бедренная грыжа",
"gender": 0,
"age_min": 45,
"age_max": 100,
"cause": [
"0"
],
"periodicity": 1,
"slug": "k41_bedrennaya_gryzha",
"lead": "выхождение внутренних органов через естественные либо приобретенные отверстия в мышечно-апоневротическом слое брюшины при сохранении целостности самой брюшины и кожного покрова",
"description": "<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Бедренная грыжа – это заболевание, при котором часть или целый орган брюшной полости выпячивается наружу через бедренный канал.</span></p>",
"etiology": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Причинами появления грыжи считаются:</span></p>\r\n<p> </p>\r\n<ul style=\"margin-top: 0; margin-bottom: 0; padding-inline-start: 48px;\">\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">анатомические особенности строения костей таза, пахового канала;</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">тяжелые физические нагрузки, профессиональные занятия спортом;</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">беременность и тяжелые роды у женщин;</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">слабость соединительной ткани;</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">хронические запоры;</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">ожирение;</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">обструктивные заболевания легких, сопровождающиеся кашлем;</span></li>\r\n<li><span style=\"background-color: transparent; font-family: Verdana; font-size: 7pt; white-space: pre-wrap;\">оперативные вмешательства в прошлом.</span></li>\r\n</ul>",
"pathogenesis": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Бедренный канал – это патологическое анатомическое образование, через которое грыжа выходит наружу. В норме такой структуры не существует, но при развитии дисбаланса между внутрибрюшним давлением и опорной функцией брюшной стенки, между мышцами и соединительнотканными пучками образуются щели. Через них происходит «выталкивание» внутренних органов.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\">Одним из ключевых факторов, увеличивающих риск развития проблемы, являются различные аномалии коллагена. Этот белок служит основой для соединительнотканных структур, из которых состоит апоневроз мышц. Из-за молекулярных дефектов в его строении формируются «слабые» места в передней брюшной стенке. При повышении внутрибрюшного давления именно они и превращаются в грыжевые ворота</span></p>\r\n<p><span style=\"font-size: 7pt; font-family: Verdana; background-color: transparent; font-variant-numeric: normal; font-variant-east-asian: normal; vertical-align: baseline; white-space: pre-wrap;\"> </span></p>",
"diagnostics": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Для подтверждения и оценки общего состояния организма назначаются следующие дополнительные обследования:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Общий анализ крови и мочи, биохимический анализ крови. Позволяют исключить воспалительный процесс и выявить сопутствующую патологию.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">ЭКГ, рентгенография органов грудной клетки. Эти тесты нужны для оценки функции легких и сердца перед предстоящей операцией.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">УЗИ патологической зоны и брюшной полости. С помощью этого метода доктор оценивает размеры грыжи, выявляет сопутствующую патологию внутренних органов.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Рентгеновская компьютерная томография (РКТ). Процедура назначается пациентам с выраженным ожирением и постоянными рецидивами грыж на фоне лечения.</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Магнитно-резонансная томография (МРТ). Показана в трудных диагностических случаях.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>",
"treatment": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Бедренная грыжа – это хирургическая патология, которая не поддается медикаментозному лечению. Наилучшие результаты обеспечивают современные малоинвазивные оперативные вмешательства.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Консервативное лечение:</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Консервативное лечение при бедренных грыжах направлено на временное улучшение самочувствия пациента на фоне подготовки к хирургическому вмешательству, во время и после его проведения. Используемые группы медикаментов:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">обезболивающие средства;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">антибиотики (при необходимости);</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">нестероидные противовоспалительные препараты.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Если пациент страдает от сопутствующей патологии внутренних органов, назначается соответствующее медикаментозное сопровождение (слабительные, ферменты, кардиологические средства и другие).</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Хирургическое лечение бедренной грыжи:</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">«Золотым стандартом» лечения бедренных грыж остается их оперативное лечение. Суть подобного вмешательства заключается в удалении грыжевого мешка и укреплении брюшной стенки. Для этого могут использоваться как собственные ткани пациента, так и искусственные сетчатые протезы. При развитии необратимого поражения частей внутренних органов, которые находятся в грыжевом мешке, они подлежат удалению.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Операция грыжесечения может выполняться различными способами. Хирург в каждом конкретном случае выбирает персонифицированную тактику с учетом размеров выпячивания, анатомических особенностей пациента и возможных рисков.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">Наиболее эффективными на сегодняшний день являются малоинвазивные вмешательства с имплантацией сетчатых протезов. Они позволяют достичь хорошего результата без повторного образования грыж у 95-99% пациентов против 85-90% при использовании обычных открытых операций.</span></p>",
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"clinical_picture": "<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">На ранних этапах заболевания пациенты жалуются преимущественно на появление эластичного бугорка в области бедра. Характерной особенностью является изменение размеров выпячивания в зависимости от положения тела. При ходьбе и во время физической нагрузки выпуклость увеличивается. В это же время больной может испытывать дискомфорт или болезненные ощущения, которые возникают из-за перерастяжения тканей вследствие повышения внутрибрюшного давления.</span></p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При возникновении осложнений могут появляться следующие проявления:</span></p>\r\n<ul>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">выраженные болезненные ощущения;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">покраснение выпячивания, отек, повышение локальной температуры тела;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">тошнота, рвота;</span></li>\r\n<li><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">появление крови в кале, отсутствие дефекации и отхождения газов.</span></li>\r\n</ul>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"> </p>\r\n<p> </p>\r\n<p style=\"line-height: 1.38; margin-top: 0pt; margin-bottom: 0pt;\" dir=\"ltr\"><span style=\"font-size: 6.999999999999999pt; font-family: Verdana; color: #000000; background-color: transparent; font-weight: 400; font-style: normal; font-variant: normal; text-decoration: none; vertical-align: baseline; white-space: pre-wrap;\">При появлении указанных признаков грыжа больше не вправляется обратно и называется невправимой. Такая ситуация требует максимально быстрой доставки пациента в хирургическое отделение для проведения оперативного вмешательства.</span></p>",
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"parent": 6675,
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}
]
}
