scholarly journals Problems of diagnostics and treatment of gastrointestinal perforations in patients with acute intestinal infections

2018 ◽  
Vol 20 (1) ◽  
pp. 145-148
Author(s):  
G M Magomedov ◽  
V P Zemlyanoy ◽  
M M Nakhumov ◽  
B B Namazov
Keyword(s):  
Diagnostic Laparoscopy ◽  
Diagnostic Errors ◽  
Diagnostic Algorithm ◽  
Study Groups ◽  
Intestinal Infection ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Abdominal Organs ◽  
Intestinal Infections ◽  
Instrumental Methods

The results of treatment of 97 patients with perforations of the hollow organs of the gastrointestinal tract were analyzed, 31 acute intestinal infections of which were verified. Clinical features of perforation of hollow organs on the background of acute intestinal infection have been revealed. A comparative analysis of clinical and instrumental methods for diagnosing perforations in patients with intestinal infections and without them was carried out. The most sensitive in identifying perforations of hollow organs in patients with acute intestinal infections instrumental methods of investigation were diagnostic laparoscopy (100%) and radiography of abdominal organs (80%). It was established that the combination of the two diseases contributes to the growth of diagnostic errors, increase in the number of common forms of peritonitis and development of the syndrome of mutual aggravation. Analysis of surgical interventions showed that in patients with confirmed diagnosis of acute intestinal infection the primary surgical interventions in most patients resulted in the formation of laparostoma with programmed relaparotomy, in connection with the presence of contraindications for the formation of a primary interintestinal anastomosis. Postoperative complications in the study groups developed in 61,3; 41.7 and 23,8% of cases, respectively. In patients with confirmed diagnosis of acute intestinal infection, lethality was 32,3%, in patients with atypical flow of perforations of hollow organs, simulating the symptoms of acute intestinal infection - 16,7 and 14,3% - in patients with perforations of hollow organs without concomitant acute intestinal infection. The results of the research testify to the relevance of the problem under study and the need to optimize therapeutic-diagnostic algorithm for this category of patients.

CLINICAL FEATURES AND DIAGNOSIS OF ACUTE APPENDICITIS IN ELDERLY PATIENTS

2020 ◽  
pp. 134-137
Author(s):  
V. V. Lesnoy ◽  
A. S. Lesnay
Keyword(s):  
Computed Tomography ◽  
Acute Appendicitis ◽  
Elderly Patients ◽  
Clinical Features ◽  
Diagnostic Laparoscopy ◽  
Diagnostic Algorithm ◽  
Objective Data ◽  
Results Of Treatment ◽  
Prognostic Groups ◽  
Instrumental Methods

Summary. Aim. To analyze features of clinic and diagnostics of acute appendicitis (AA) in elderly patients. Materials and methods. The work is based on the analysis of the results of treatment of 38 patients with AA clinic at the age > 60 years. Results. The patients were divided into prognostic groups according to the Alvarado scale. The diagnostic algorithm for each group is compiled and the characteristics of clinical features, laboratory parameters, instrumental methods are given. Conclusion. Only 23.6 % of patients older than 60 years are diagnosed with AA based on objective data, which is why computed tomography or diagnostic laparoscopy is required in the diagnostic algorithm.

scholarly journals FEATURES OF DIFFERENTIAL DIAGNOSIS OF URGENT SURGICAL ABDOMINAL PATHOLOGY DURING A PANDEMIC OF CORONAVIRUS INFECTION

2021 ◽  
pp. 5-8
Author(s):  
V. V. Lesnoy ◽  
A. S. Lesna ◽  
V. A. Filonenko
Keyword(s):  
Differential Diagnosis ◽  
Clinical Symptoms ◽  
Diagnostic Algorithm ◽  
Surgical Pathology ◽  
Sonographic Examination ◽  
Advantages And Disadvantages ◽  
Abdominal Organs ◽  
Rapid Tests ◽  
Coronavirus Infection ◽  
Instrumental Methods

Summary. Aim. To analyze the features of differential diagnosis of urgent surgical pathology during a coronavirus infection pandemic. Materials and methods. The work is based on the analysis of the results of additional examination of 28 patients at the admission department, who sought medical help in an urgent manner. Results. The advantages and disadvantages of using instrumental methods for detecting atypical forms of coronavirus infection and acute abdominal pathology are analyzed. Based on this, a diagnostic algorithm was developed using express tests for the determination of COVID-19 and urgent ultrasound protocols, which made it possible to identify lung lesions without clinical symptoms in 8 (28.6 %) patients, and to confirm acute surgical pathology in 5 (17.9 %) patients. Conclusion. Еxamining patients with suspected acute abdominal pathology for the purpose of differential diagnosis with the gastrointestinal form of COVID-19, it is necessary to use rapid tests for detecting antibodies to coronavirus infection and sonographic examination of the abdominal organs (FAST protocol), chest organs (BLUE protocol).

scholarly journals Analysis of surgical treatment of liver hemangiomas

2021 ◽  
Vol 38 (4) ◽  
pp. 129-141
Author(s):  
I. N. Mugatarov ◽  
M. F. Zarivchatsky ◽  
V. A. Samartsev ◽  
L. A. Bankovskaya ◽  
E. D. Kamenskikh ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Outpatient Basis ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Abdominal Organs ◽  
Right Lobe ◽  
Perioperative Safety ◽  
Surgical Tactics ◽  
The Right ◽  
Ct And Mri

Objective. Development of criteria for optimal tactics of surgical treatment of liver hemangiomas of various sizes and localizations. Materials and methods. A retrospective analysis of 247 patients with hepatic hemangiomas observed on an outpatient basis and in a hospital was carried out; 59 of them (23.89 %) were operated including 12 men and 47 women over the period of 19992019. Liver resection with hemangioma was performed in 30 patients, hemangioma enucleation in 21, X-ray endovascular occlusion in 8 patients. The diagnosis was established on the basis of ultrasound of the abdominal organs, CT and MRI with contrast as well as angiographic research methods. Results. The postoperative complications developed in 4 (6.78 %) cases: reactive pleurisy was detected in 2 patients after the right-sided hemihepatectomy, hematomas in the resection zone of segments of the right lobe of the liver with a tumor were diagnosed in 2 patients. All complications were eliminated by conservative measures. There were no lethal outcomes. Conclusions. Surgical treatment of patients with hemangiomas includes resection of the liver with a tumor, enucleation of the hemangioma, and various types of local destruction. In order to reduce the blood circulation of the tumor and decrease the risk of intraoperative blood loss, the ECA of the branches of the hepatic artery was indicated. A comparative analysis of the results of treatment of patients with liver hemangiomas using various methods of surgical interventions made it possible to develop optimal surgical tactics, a system of intra- and perioperative safety in this category of patients.

scholarly journals Modern technology in the treatment of patients with postoperative ventral hernias

2018 ◽  
Vol 10 (1) ◽  
pp. 37-42
Author(s):  
B. V. Sigua ◽  
V. P. Zemlyanoy ◽  
A. S. Sokolova ◽  
D. F. Cherepanov ◽  
S. A. Vinichuk ◽  
...  
Keyword(s):  
Diagnostic Algorithm ◽  
Modern Technology ◽  
Control Group ◽  
Spiral Computed ◽  
X Ray ◽  
Flow Energy ◽  
Results Of Treatment ◽  
Abdominal Organs ◽  
Analysis Of Results ◽  
Ventral Hernias

The analysis of results of treatment of 113 patients with postoperative ventral hernias was carried out patients divided into two groups. 74 patients have received treatment (II (control) group) from 2013 to 2014 year. Patients of the control group were examined according to the accepted diagnostic algorithms, in addition to physical examination algorithm include chest and abdominal x-ray examination, ultrasound diagnosis of abdominal organs and fibro-esophagogastroduodenoscopy. Plastic by reticular endoprostheses was carried out in various methods. Methods have been chosen directly by surgeon during the operation. The draining of the postoperative wound was mandatory. Main (I) group included 39 patients who received treatment from 2015 to 2016. The diagnostic algorithm was supplemented with fibrocolonoscopy and spiral computed tomography, and the plastic method was predominantly sub-lay. Hypoderma treatment by high-temperature oscillating plasma flow energy according to the original technique for the prevention of lymphorrhea was provided to all patients. Maims were mostly sutured tightly. This approach allowed to reliably reduce frequency complications from 13.4% (14) to 1.8% (2) and, as a consequence, the length of stay of the patient in the hospital.

SURGICAL CORRECTION OF POSTOPERATIVE INTRAABDOMINAL COMPLICATIONS IN PATIENTS WITH COLORECTAL CANCER

2017 ◽  
Vol 63 (5) ◽  
pp. 734-737
Author(s):  
Eskender Topuzov ◽  
Yelena Yerokhina ◽  
Eldar Topuzov ◽  
Yelena Drogomiretskaya ◽  
Vyacheslav Balashov ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Colon Cancer ◽  
Operation Time ◽  
Surgical Correction ◽  
Surgical Interventions ◽  
Results Of Treatment

The results of treatment of postoperative intraabdominal complications in patients who underwent surgical interventions for colon cancer were studied. The effect of the re-operation time was assessed. The volume of surgical correction was discussed in case of insufficiency of anastomosis sutures. The results of the study made it possible to identify the most rational timing and scope of surgical correction of postoperative intraabdominal complications in patients with colorectal cancer.

Pituitary Apoplexy and Its Effect on Vision

Neurosurgery ◽  
1991 ◽  
Vol 29 (5) ◽  
pp. 669-675 ◽  
Author(s):  
Robert M. McFadzean ◽  
David Doyle ◽  
Roy Rampling ◽  
Evelyn Teasdale ◽  
Graham Teasdale
Keyword(s):  
Pituitary Adenoma ◽  
Clinical Diagnosis ◽  
Clinical Features ◽  
Visual Function ◽  
Pituitary Apoplexy ◽  
Diagnostic Errors ◽  
Large Series ◽  
Ocular Motility ◽  
Pathological Findings ◽  
Results Of Treatment

Abstract A series of 15 patients with a clinical diagnosis of pituitary apoplexy is reviewed. Clinical features are highlighted, with stress on the defects of visual function and ocular motility, and the associated endocrine abnormalities are described. Potential diagnostic errors and their significance are considered. The incidence of this complication in a large series of pituitary adenoma patients is measured, and the radiological and pathological findings are recorded. The results of treatment by surgery and/or radiotherapy and/or bromocriptine are assessed, particularly in relation to visual consequences, and compared with previous reports in the literature, which are reviewed.

scholarly journals Features of the decidualized endometriosis diagnosis and course during pregnancy

2021 ◽  
Author(s):  
AA Gerasimova ◽  
LA Asyrafyan ◽  
IB Manuchin ◽  
MV Shamarakova ◽  
MS Miryasova ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Pregnant Women ◽  
Ultrasound Imaging ◽  
Imaging Data ◽  
Surgical Interventions ◽  
Rational Treatment ◽  
Borderline Tumors ◽  
Results Of Treatment ◽  
Risk Of Malignancy ◽  
Risk Of Malignancy Index

Currently, surgical treatment aimed to exclude the malignant ovarian tumors is performed in almost 90% of patients with decidualized endometrial cysts (DEC). However, unnecessary surgical interventions increase the risk to maternal and fetal health. The study was aimed to perform a differential diagnosis of DEC in pregnant women in order to define the rational treatment. A total of 82 female patients were included in the study: 63 had endometrial cysts (EC), 16 had DEC, 3 had rare forms of endometriosis, and 10 had ovarian serous papillary borderline tumors. When performing the diagnostic ultrasound, our proposed model was used. The ultrasound imaging data obtained were juxtaposed with the concentration of the protein tumor markers (СА-125), the risk of malignancy index (RMI) was calculated, and the morphological assessment of the masses was performed. The ultrasound imaging parameters, being the most valuable for differential diagnosis of EC, DEC, and serous borderline tumors, were as follows: the altered mass wall thickness, the existence and shape of papillary masses, avascular echogenic inclusions with blurry contour, blood circulation and arrangement of blood vessels, ascites. The frequency analysis revealed the differences between groups based on the ultrasound imaging data (in 60–100% of observations). Histological examination revealed the differences between groups in 100% of observations. Our findings have made it impossible to prolong pregnancy in patients with DEC without performing surgery. The results of treatment provided to patients with DEC during pregnancy were worse compared to those in patients with no prominent decidualization in ovarian EC. Today, the diagnosis of DEC and the treatment of patients during pregnancy remain unsophisticated. Further clinical observation and the search for more reliable methods of the diagnosis and rational treatment of pregnant women with DEC are required.

scholarly journals MODERN TRENDS IN THE TREATMENT OF ACUTE ADHESION IN INTESTINAL OBSTRUCTION

2020 ◽  
pp. 58-61
Author(s):  
V. V. Lesnoy ◽  
A. S. Lesnay
Keyword(s):  
Intestinal Obstruction ◽  
Inpatient Treatment ◽  
Conservative Therapy ◽  
Postoperative Treatment ◽  
Surgical Interventions ◽  
Surgical Department ◽  
Results Of Treatment ◽  
Restoration Time ◽  
Days Open ◽  
Adhesive Obstruction

Summary. Aim. To perform the modern tactics of acute adhesive obstruction (AAO) treatment. Materials and methods. The basis of the work is the analysis of the results of treatment of 38 patients hospitalized in an urgent order to the surgical department with the clinic AAO. Results. 20 (52.6 %) patients with the background of conservative therapy, the phenomenon of intestinal obstruction was regressed. Repeated hospitalization during the year with the hospital was required by AAO 2 (5.3 %) patients. Laparoscopic adhesion was performed 4 (10.5 %) patients whose average intestinal restoration time was (1.8±1.2) days, and the duration of postoperative inpatient treatment was (5.1±1.3) days. Open surgical interventions were performed 14 (36.8 %) patients, in whom the period of restoration of the intestine function was (3.8±1.5) days, and the duration of postoperative treatment was (10.1±1.2) days. Conclusion. Conservative therapy is effective in 52.6 % of patients. Laparoscopic adhesion is indicated in the absence of peritoneal symptoms, if ≤ 2 laparotomies were noted in the history, with a peritoneal index of adhesion ≤ 9 points.

scholarly journals Therapeutic tactics in the deep forms of rectal abscesses complicated by fournie gangrene

2020 ◽  
Vol 73 (2) ◽  
pp. 293-297
Author(s):  
Oleh E. Kanikovskyi ◽  
Andrii V. Osadchyі ◽  
Sergey I. Androsov ◽  
Anatolii V. Tomashevsky ◽  
Oleh A. Yarmak ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Antibacterial Therapy ◽  
Treatment Duration ◽  
Complex Treatment ◽  
Surgical Interventions ◽  
Results Of Treatment ◽  
Surgical Clinic ◽  
Modern Technologies ◽  
Clinical Emergency ◽  
Early Surgical Treatment

The aim: To conduct an analysis of the complex treatment of severe forms of rectal abscesses complicated by NF. Materials and methods: The results of treatment in 471 patients with deep forms of RA was performed. In 38(8%) the spread of the process and rotten-necrotic affection of the perineal fascia. Patients were treated at the surgical clinic of the medical faculty №2, VNPMMU, and Vinnytsya Clinical Emergency Hospital in the period from 2010-2018. Results: Total lethality 8(1,7%). Mortality in GF was 8(19,5%). It is worth noting the reduction of the treatment duration against the background of the modern technologies usage in the period from 2016 to 12 days in relation to the total figure of 15 days. Conclusions: Early surgical treatment, adequate necrectomy, fasciotomy and antibacterial therapy stop the necrotic process. The active aspiration reduces the timing of wound cleansing and further ensures the accelerated implementation of reconstructive surgical interventions.

scholarly journals HYBRID INTERVENTIONS IN EMERGENCY ANGIOSURGERY

2021 ◽  
Vol 29 (2) ◽  
pp. 250-256
Author(s):  
S.V. Mshar ◽  
◽  
V.N. Zasimovich ◽  
V.A. Asanovich ◽  
E.Ya. Nikolenko ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Perioperative Complications ◽  
Ankle Brachial Index ◽  
Lower Extremities ◽  
Primary Patency ◽  
Complete Revascularization ◽  
Type B ◽  
Hybrid Surgery ◽  
Surgical Interventions ◽  
Results Of Treatment

Objective. To improve the results of treatment of patients with multilevel atherosclerotic lesions and aortic dissection. Methods. In 2019 year 16 hybrid surgical interventions on arteries of lower extremities and 1 hybrid intervention for aortic dissection type B were made in Brest Regional Hospital. Most of the patients were men (15 out of 16), the average age was 60.2±6.4 (M±σ) years. Disease was staged according to the Fontaine-Pokrovsky classification: 4 patients (25%) - IIb, 8 (25%) - III, 4 (25%) - IV. The type of surgery was determined by the level of occlusion / stenosis (according to Doppler ultrasound and angiographic examination) and the state of the outflow tract. According to the TASC II classification, all patients were class C or D. Four groups of hybrid interventions on the arteries of the lower extremities were identified: hybrid on the ilio-femoral segment (n=9), hybrid on the femoral-popliteal segment (n=4), hybrid on the femoral segment (n=1), hybrid on the aorto-iliac segment (n=2). Results. Technical success was achieved in 100% of cases. In 1 case thrombosis of the superficial femoral artery occurred, which did not require reconstruction due to compensated collateral blood flow, and 1 case of death from acute heart failure. Primary patency was achieved in 93.75% of cases. Duration of hybrid surgery 174.2±67.3 (M±σ) min. Duration of the open stage of the operation - 72.85±30.3 (M±σ) min. The augmentation of the ankle-brachial index (ABI) was 0.26±0.15 (M±σ). Hybrid interventions were performed in the X-ray operating room and always from one vascular access. The amount of iodine-contrasting substance used is 150.8±68 (M±σ) ml. Conclusion. The use of hybrid interventions provides complete revascularization of lower extremities and minimizes risks of perioperative complications during implantation of aortic stent grafts in type B aortic dissection. Hybrid operations should be considered as the most perspective direction in the development of angiosurgery.

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