Tắc Ruột Non-Điều Trị

The correct answer is that all of the options A, B, C, and D are correct. The question is asking about the effects of using a nasogastric tube in a patient with intestinal obstruction. The options state that using the tube can reduce abdominal distention, improve breathing difficulties, alleviate nausea and vomiting, and prevent gastric reflux into the respiratory tract. Therefore, all of the options are correct in describing the benefits of using a nasogastric tube in this situation.

The correct answer is D because all of the cases mentioned (A, B, and C) are indications for surgery in cases of small bowel obstruction. In case A, the obstruction is caused by a tumor in the small bowel, which typically requires surgical intervention. In case B, the obstruction is due to adhesions from previous abdominal surgery, and if conservative treatment has failed after 6 months, surgery is usually necessary. In case C, if the non-operative treatment for adhesive small bowel obstruction fails after 48 hours, surgery is usually required to relieve the obstruction.

The correct answer is "Mở đoạn ruột bên dưới chỗ tắc ra ngoài". This option is not a recommended technique when performing surgery for intestinal obstruction. Opening the intestine below the obstruction can lead to spillage of intestinal contents into the abdominal cavity, increasing the risk of infection and other complications. It is generally preferred to remove or bypass the obstructed segment of the intestine to restore normal bowel function.

The correct answer is that all of the options A, B, C, and D are correct. This means that after surgery for bowel obstruction, complications can occur in the respiratory system, cardiovascular system, kidneys, and as a result of infection.

The purpose of the second-look surgery after the initial surgery to untwist the intestines is to determine whether the untwisted segment of the intestine is viable or not. This means that the surgeon wants to assess whether the untwisted segment of the intestine is still alive and functioning properly. Therefore, the correct answer is B - to see if the untwisted segment of the intestine is viable.

In the given question, the correct answer is E, which states that options A, B, and C are all correct. This means that all of the mentioned cases, including small bowel obstruction caused by malignant tumors, benign tumors, and inflammatory fibroid polyps of the small bowel, may require surgical treatment.

The most important clinical sign to evaluate a twisted appendix's viability is the presence of mobility. This indicates that the twisted appendix still has blood supply and can continue to function properly. The other options, such as color, temperature, and edema, may provide additional information but are not as crucial in determining the viability of the twisted appendix. The presence of a pulse at the hanging mesentery is also a significant indicator of blood supply to the twisted appendix.

The correct answer is E because all of the options A, B, C, and D are incorrect. None of the options provide the correct surgical principle for treating a patient with small bowel obstruction.

Lactate Ringer is the correct choice for replenishing fluids and electrolytes in a patient with bowel obstruction. It is a balanced solution that contains sodium, chloride, potassium, calcium, and lactate. These components help restore electrolyte balance and provide energy to the body. Natri chloride 0.9% and glucose 5% are not suitable choices as they do not provide the necessary electrolytes and nutrients needed for rehydration and electrolyte replenishment.

The correct answer is D because when dealing with a twisted bowel, a "limited resection" refers to cutting the bowel at a position where there is a high likelihood of healing. This means that the surgeon will cut the bowel at a location where the tissue is healthy and has a good blood supply, increasing the chances of successful healing after the resection.

The correct answer is C-100 cm. This is because the minimum length of the remaining intestine needed to maintain its functionality is 100 cm. If the intestine is shorter than this, it may not be able to properly absorb nutrients and perform its digestive functions.

The effectiveness of conservatively treating intestinal obstruction is evaluated through clinical assessment. This involves observing and evaluating the patient's symptoms, physical examination findings, and overall response to treatment. Clinical assessment helps in determining the progress of the treatment and whether any further intervention is required. Therefore, clinical evaluation is an important tool for assessing the effectiveness of conservative treatment for intestinal obstruction.

The correct answer is E, which states that options A, B, C, and D are all incorrect. This means that none of the options mentioned in the question are correct in relation to the surgical technique for treating intestinal obstruction caused by adhesions.

The correct answer is E because all of the given cases of non-obstructive ileus have indications for internal medicine treatment. This means that in all of these cases, the treatment can be managed without the need for surgery or invasive procedures.

Bán tắc ruột non do dính là nguyên nhân phổ biến dẫn đến bệnh lý này. Phẫu thuật nội soi được sử dụng để điều trị bệnh này.

The correct answer is E because options A, B, and C are all incorrect methods for assessing the viability of a twisted bowel. Option A suggests using a temperature probe to measure the surface temperature of the twisted bowel, which is not a valid method. Option B suggests using a Doppler ultrasound probe to assess blood flow in the bowel, which is also not a valid method. Option C suggests marking white blood cells with a radioactive substance and then using a Wood's lamp to visualize the twisted bowel, which is not a recognized technique. Therefore, all of the given options are incorrect.

If a patient has almost all of their small intestine removed, they have a chance of survival if they have a remaining segment of at least 50 cm of the large intestine (colon). The large intestine, specifically the colon, plays a crucial role in absorbing water and electrolytes from the undigested food, as well as forming and storing feces. Without a sufficient length of the large intestine, the patient would not be able to absorb essential nutrients and fluids, leading to severe complications and potential death. Therefore, having a minimum of 50 cm of the large intestine remaining is necessary for the patient's survival.

The correct answer is D because glucose 5% solution is not a treatment for conserving bowel obstruction. It is a solution used for intravenous hydration and does not directly address the underlying cause of the bowel obstruction. Other options such as placing a nasogastric tube, administering intravenous antibiotics, and prescribing antispasmodic medications are more appropriate interventions for conserving bowel obstruction.

After untwisting a long twisted segment of intestine in a patient with twisted bowel, the next step should be to leave the segment of intestine in the abdominal cavity, close the abdomen, and reassess the segment of intestine after 24 hours. This approach is chosen when there is hope for the twisted segment of intestine to recover.

The purpose of the second-look surgery after the initial surgery to remove a twisted intestine is to determine whether the intestinal anastomosis (the connection between two segments of the intestine) has healed properly or if there are any complications such as leakage or narrowing. This is important to ensure that the patient's condition has improved and to make any necessary adjustments or interventions if needed.

Opening the lumen of the intestine or performing an anastomosis increases the risk of postoperative ileus. This is because these procedures can cause inflammation and swelling in the intestines, leading to a temporary paralysis of the intestinal muscles. This paralysis can result in a buildup of gas and fluids, causing bloating, pain, and a delay in the return of normal bowel function. Therefore, minimizing the opening of the intestine or performing an anastomosis is preferred to reduce the risk of postoperative ileus.

The correct answer is E because none of the options A, B, C, or D are the appropriate next steps after untwisting a segment of twisted intestine. The correct course of action would depend on the specific condition and circumstances of the patient, and would require a thorough evaluation by a medical professional.