From Big Medical Encyclopedia

SOLAR PLEXITIS (solaritis; lat. solaris solar + - itis; synonym solar plexitis) — defeat of an abdominal brain of degenerative or inflammatory character.

In etiologies Pages matter mechanical factors — external, napr, blow to the epigastric area, and internal, napr, a splanchnoptosia, aneurism of a belly part of an aorta, a sharp lordosis; acute and hron. infections (malaria, syphilis, tuberculosis, is more rare a brucellosis, sepsis); exogenous (lead, alcohol) and endogenous intoxications (helminthic invasions, colitis with dysfunction of intestines). Most often S. arises as a complication of inflammatory process of a peritoneum — peritonitis, a perivisceritis (a perihepatitis, a periduodenitis, etc.). Emergence of symptoms of pathology of an abdominal brain at osteochondrosis of chest department of a backbone owing to traumatization of preganglionic sympathetic fibers is possible.

The main pathogenetic mechanisms a wedge, manifestations are disturbances of integrativnokoordinatsionny activity of an abdominal brain. Developing of so-called solar crises can be connected with disturbance of circadian rhythms of vegetative providing, influence of exogenous factors, hypothalamic insufficiency, neurotic disturbances, the phenomena repercussions (see).

Morphologically at S. dystrophic, degenerative and atrophic and necrobiotic changes in nervous cells and fibers of a texture are found various degree.

Wedge, picture The page consists of constant and paroxysmal symptoms. The pains in epigastric area which are not connected with meal, amplifying in a standing position belong to constant symptoms or lying on spin. Paroxysmal manifestation are solar crises, frequency of approach to-rykh is various (ot1 — 2 times a month to developing daily). Solar crises arise at different times days, are quite often provoked by a physical or emotional overstrain, a weather changing. There are sharp, burning, terebrant pains in epigastric area irradiating in a waist, the lower chest vertebras on the course of intercostal nerves, on all stomach. The patient accepts a forced dorsal decubitus with the legs bent in knees and given to a stomach. The meteorism, strengthening of a vermicular movement of intestines, often tachycardia, increase in the ABP are noted, nausea and vomiting are more rare. The painful attack, as a rule, is affektivno painted: is followed by tears, vasomotor reactions, sensation of fear of death. Duration of an attack — of several hours to 1 days.

During the periods between solar crises asthenoneurotic manifestations (a sleep disorder, fatigue, headaches, irritability, lability of mood) are frequent, are registered a vagal orientation of a tone of c. N of page, dysfunction of abdominal organs — the locks, spasms of a gall bladder sometimes reminding a picture of hepatic colic, disturbance of motor function of a stomach.

Diagnosis Page as an independent disease demands big care, first of all S. can imitate a wedge, a picture of an acute abdomen (see). The diagnosis can be made only after an exception of other diseases of abdominal organs. It is established on the basis of characteristic painful attacks and identification by means of a palpation of painful points: points on border between an upper and average third, between an average and lower third of the line connecting a xiphoidal shoot to a navel and also a point — a so-called solar nail, to-ruyu find below the line connecting the front ends of the X edges on the right. For assessment of a condition of sympathetic or parasympathetic systems investigate vegetative manifestations at rest, vegetative reactivity (by the dosed exercise and pharmacological stresses), vegetative providing different types of activity, a number of vegetative reflexes — an Aschner's reflex — Danyini (see. Oculocardic reflex ), Thomas's reflex, a reflex of Ru, test with sweating (see. Vegetative reflexes), conduct electrophysiologic and pharmakodinamichesky researches.

Differential diagnosis carry out with abdominal crises at back to tabes (see), a periodic disease (see), at to-rykh attach major importance to other displays of these diseases.

Treatment includes stopping of solar crises by means of anesthetics and antispasmodics (Nospanum, a papaverine, Platyphyllinum), adrenoblockers, tranquilizers and use in the mezhpristupny period of Belloidum, bellaspon, the central and peripheral cholinolytics (amizyl, metamizyl, etc.), ganglioblokator (Pentaminum, etc.), alpha and beta adrenoblockers (Pyrroxanum, anaprilin), spasmolytic and antihistamines. Carry out physical therapy — an electrophoresis with novocaine on area of a projection of an abdominal brain, mud applications on the Th7-12 area of segments, radonic bathtubs.

Forecast for life favorable; acute S. at timely treatment comes to an end with an absolute recovery.

Bibliography: Bulygin I. A. The structurally functional organization vegetative gangliyev and their integrativnokoordinatsionny function, in book: Fiziol. vegetative nervn. sist., under the editorship of O. G. Baklavadzhyan, etc., page 211, L., 1981; Vane A. M., Solovyova A. D. and Kolosova O. A. Vegeto-vascular dystonia, M., 1981; Markelov G. I. Diseases of vegetative system, Kiev, 1948; R at with e recreation center and y I. I. Clinical neyrovegetolo-giya, M., 1950; Четвериков^Н. C. Diseases of the autonomic nervous system. M, 1968; Laignel-Lavasti-n e M. Pathologie du sympathique, P., 1924.

P. G. Lekar, V. A. Makarova.