Case of surgical treatment of the heavy nonspecific ulcer colitis complicated by massive bleeding

Complex treatment of patients with nonspecific ulcerative colitis is one of the most difficult problems of modern gastroenterology and is characterized by ulcerative-destructive changes of its mucous membrane. The main indications for surgical treatment of patients with nonspecific ulcer colitis are its complications, as well as the inefficiency of multi-component conservative therapy. The case of treatment of a young patient suffering from ulcerative colitis complicated by bleeding is considered. The possibility of performing radical surgical interventions for complications of ulcerative colitis is shown. One of the most dangerous, life-threatening complications of ulcerative colitis is bleeding. Most operations in patients with bleeding are performed urgently in extremely adverse conditions, due not only to the severity of bleeding, posthemorrhagic anemia and significant violations of hemostasis, but also the presence of concomitant complications of nonspecific ulcerative colitis, as well as associated multiple organ dysfunction. Thus, during the hospitalization of the patient, which amounted to 48 days, the patient underwent 11 open surgical interventions. For proper treatment it took more than 25 liters of blood products. Attention is paid to the favorable long-term result of treatment of patients with this pathology. In the treatment of this category of patients should be aware of the possibility of using minimally invasive technologies. The urgency of the problem under consideration is increased due to the steady increase in the incidence of nonspecific ulcerative colitis, which is naturally accompanied by an increase in the frequency of complications and disability of patients, a significant part of whom are the most efficient and socially active patients aged 20-40 years, with the causes and mechanisms of their development are not fully known.

Local and therapeutic intervention in the management of dushta vrana w.s.r. to tropic ulcer – a case study

An ulcer is a break in the continuity of the covering epithelium- skin or mucous membrane. Trophic ulcer is a kind of nonspecific ulcer. Wound healing is a mechanism where the body attempts to restore the integrity of the injured part. A clear wound heals earlier with a minimum scar as compared to contaminated wound. Several factors affect the normal process of wound healing such as the site of ulcer, vascular insufficiency, malnutrition, neurological deficit and drugs like corticosteroids. AcharyaSushruta mentioned 60 Upakramasfor the management of Vrana, Kashay Are among them. With NyagrodhadiKashaypatient was treated successfully and after the follow up ulcer was healed completely and the patient showed marked improvement. A case report of 26-year young male presented with an ulcer over the left foot which was painless, slough on the floor and loss of sensation over the distal 2/3rd of left foot has been presented here.

Comparison between Outcome of Wedge Excision of Perforation Site and Trimming of Perforation Margin Followed by Primary Repair in the Management of Ileal Perforation

The aim of this study is to compare between the outcome of wedge excision of perforation site and trimming of perforation margin followed by primary repair in the management of ileal perforation in selected patients. This is an observational study with data from department of Surgery, Sir Salimullah Medical College and Mitford Hospital during February, 2007 to July, 2010. The study included 108 patients of ileal perforation of 15-67 years of age. All patients were treated by primary repair after either wedge excision of perforation site (Group I) or trimming of perforation margin (Group II). Perforation due to typhoid is common in both groups. Abdominal pain, fever, abdominal distention, constipation and vomiting were more frequent in both groups of patients. Signs of peritonitis were observed almost all the patients. Pneumoperitoneum was found 77.8% in group I and 66.7% in group II in X-ray. In ultrasonography ascitis and distended bowel loop was found 44.4% in group I and 66.7% in group II. Typhoid, tuberculosis, nonspecific ulcer and chronic nonspecific ulcer were found in histopathology. Post-operative complications were more in group II. Anastomotic leakage was found 18.5% in group I and 38.9% in group II. Prolonged ileus was observed 16.7% in group I and 33.3% in group II. Anastomotic leakage and Prolonged ileus difference were statistically significant (p<0.05). The mean duration of hospital stay was significantly (p<0.05) higher in group II, where the mean(±SD) duration of hospital stay was 14.2±7.2 days in group I and 18.1±8.9 days in group II. Mortality was observed 9.3% only in group II. So Wedge excision followed by primary repair is better in terms of post operative mortality and morbidity in the management of ileal perforation in selected patients.Medicine Today 2017 Vol.29(2): 17-20

Peculiarities of blood rheology in patients with chronic generalized periodontitis combined with gastrointestinal tract disturbances

The aim of investigation is to study blood rheological properties in patients with chronic generalised periodontitis combined with gastrointestinal tract disturbances. 205 patients have been examined including those with erosive ulcerous involvement of gastroduodenal area — 51, with stomach ulcer and duodenal ulcer — 62, with chronic colitis — 39, with nonspecific ulcer colitis — 53. Blood viscosity properties, indices of erythrocyte aggregation and deformability, rate of oxygen delivery to tissues have been evaluated by rotary viscometer АBR-2 (Russia). It has been revealed that blood rheological properties in patients with chronic generalised periodontitis combined with gastrointestinal tract disturbances had been disturbed, that was accompanied with the blood viscosity rise, erythrocyte aggregation increase and with the decrease of deformability and rate of oxygen delivery to tissues. The degree of violations in blood rheology indices was mostly expressed under chronic and plural erosions of gastroduodenal area, duodenal ulcer and severe course of chronic nonspecific ulcer colitis.