scholarly journals Possibilities of Laparoscopic Decompression of Celiac Trunk in the Treatment of Dunbar Syndrome

2017 ◽  
Vol 10 (2) ◽  
pp. 90-95
Author(s):  
Yury Viktorovich Ivanov ◽  
Andrey Valeryevich Chupin ◽  
Dmitry Nikolaevich Panchenkov ◽  
Pavel Yuryevich Orekhov ◽  
Aleksey Alekseevich Terehin
Keyword(s):  
Clinical Case ◽  
Multislice Computed Tomography ◽  
Conservative Therapy ◽  
Pain Syndrome ◽  
Celiac Trunk ◽  
Gastrointestinal Diseases ◽  
Medical Community ◽  
Slight Pain ◽  
Cosmetic Effect ◽  
Dunbar Syndrome

Presented clinical case laparoscopic decompression of celiac trunk syndrome of Dunbar. In most cases, the diagnosis of syndrome of compression of the celiac trunk is by exclusion of other gastrointestinal diseases. Sure, it tells about lack of awareness among the medical community about this specific and rare pathology, as well as a possible skeptical attitude towards it related professionals. The main methods of diagnostics of a syndrome of Dunbar are: ultrasonic duplex scanning of the abdominal aorta, multislice computed tomography and angiography with a respiratory samples. The indication for surgical treatment is the ineffectiveness of conservative therapy, the preservation of the leading symptoms of abdominal ischemia on the ground proved critical in compression of the celiac trunk. Currently, laparoscopic decompression of celiac trunk syndrome Dunbar is the operation of choice. The obvious advantages of laparoscopic surgery are less blood loss, a slight pain syndrome in the postoperative period, short hospital period and better cosmetic effect. In the clinic, where surgeons proficient in the technique of laparoscopic procedures, the surgery can be performed quickly, safely, and efficiently. Additional intervention in the form of endovascular correction is not required in all patients and can be performed in a delayed order.

scholarly journals Modern views on the problem of sepsis

2020 ◽  
pp. 18-26
Author(s):  
V.S. Kopcha
Keyword(s):  
Infectious Disease ◽  
Inflammatory Response ◽  
Clinical Case ◽  
Conservative Therapy ◽  
Medical Community ◽  
Etiological Factors ◽  
Systemic Reactions ◽  
Almost All ◽  
Increased Activity

BACKGROUND. By defining the cornerstone of sepsis as the “systemic” of the inflammatory response in the form of cytokine violations, the authors of the corresponding concept are forced to recognize the etiological factors almost all pathogens of infectious diseases, which naturally go with the increased activity of cytokines in serum. Without diminishing the importance of these components of inflammation, one should pay attention to the postulate that not only viruses and protozoa never cause sepsis, but also all non-bacterial pathogens are not etiological factors of this disease, although they lead to severe systemic reactions accompanied by an increase in the level of proinflammatory cytokines. OBJECTIVE. The purpose of the work is to draw the attention of physicians to the discrepancy between the new notions about sepsis imposed on the medical community and accepted not only by anesthetists, resuscitative surgeons and surgeons, but also by many infectionists. MATERIALS AND METHODS. A detailed analysis of the clinical case of sepsis in a young woman is presented, which, due to adequate surgical and long-term conservative therapy, has safely recovered. CONCLUSIONS. Sepsis is a generalized acyclic infectious disease of the bacterial and/or fungal etiology that develops in an immunodeficient organism with characteristic pathomorphological and pathologist changes in organs and tissues.

Possibilities of correction of the statodynamic stereotype violations in patients with dorsopathy at the cervical-thoracic level

2021 ◽  
pp. 20-33
Author(s):  
V. O. Belash ◽  
A. E. Vorobyova ◽  
D. A. Vasyukovich
Keyword(s):  
Cervical Spine ◽  
Range Of Motion ◽  
Exercise Therapy ◽  
Frontal Plane ◽  
Pain Syndrome ◽  
Main Group ◽  
Medical Community ◽  
Control Group ◽  
Active Movement ◽  
Social Significance

Introduction. Back pain is not only a high prevalence, but also a costly health problem. That is why the search for new and the optimization of existing methods of dorsopathies treatment acquire an important clinical and medico-social significance. In recent years, the medical community has increased the interest in non-drug methods of treatment, including osteopathy. Previous studies have substantiated the possibility of effective application of osteopathic correction methods in the treatment of patients with dorsopathies. A specific object of the osteopath′s work is somatic dysfunction (SD). And if earlier SD was perceived from the standpoint of purely biomechanical disorders, then in recent years there have been serious changes in understanding the heterogeneity of this state nature. The biomechanical, rhythmogenic and neurodynamic components are conventionally distinguished in the structure of SD. One of the neurodynamic disorders types is the violation of motor stereotypes, the so-called static-dynamic disorders, revealed through special dynamic tests and manifested in the functional impossibility of building of active movement at various levels. At the same time, the generally accepted biomechanical approaches do not allow to completely eliminate violations of the statodynamic stereotype.The goal of research — the study was to research the effectiveness of the osteopathic approach using in combination with kinesitherapy for correction of the statodynamic stereotype violations in patients with dorsopathy at the cervicothoracic level.Materials and methods. A controlled randomized prospective study was conducted on the basis of a private rehabilitation center «Ezramed-Clinic» in Omsk in the period from February 2019 to December 2019. 52 patients with a diagnosis of dorsopathy at the cervicothoracic level were observed. 12 people were knocked out during the study in accordance with the exclusion criteria. As a result, 40 patients participated in the study. Depending on the applied treatment method, the patients were divided by simple randomization into two groups (main and control), each of which consisted of 20 people. Both groups of patients received osteopathic correction three times with a frequency of receptions 1 time in 7–10 days. The main group of patients additionally independently performed daily for 10 minutes a set of exercises aimed to restore the disturbed motor stereotypes (normal synkinesis). The control group of patients additionally independently performed a set of exercise therapy for the cervical spine every day for 10 minutes. All patients, regardless of the group, underwent an osteopathic examination before and after treatment with the formation of an osteopathic conclusion; the severity of pain syndrome and the volume of active movements in the cervical spine were assessed. The severity of the pain syndrome and the range of active movements were assessed before and immediately after treatment, as well as 3 months after the first session.Results. The use of osteopathic correction in conjunction with kinesitherapy (both special exercises and a complex of exercise therapy) in patients with a diagnosis of dorsopathy at the cervicothoracic level leads to a statistically significant increase in the range of motion in the cervical spine in the sagittal and frontal planes (p<0,05). The combination of osteopathic correction together with exercise therapy in patients of the control group led to a statistically more significant increase (p<0,05) in the range of motion in the cervical spine in the frontal plane after treatment compared with the results of the main group. However, 3 months after treatment, the indicators in patients of both groups did not have statistically significant differences.The combination of osteopathic correction in conjunction with kinesiotherapy in the form of special exercises for the motor stereotype correction in the main group of patients with diagnosed dorsopathy at the cervicothoracic level led to a statistically significant (p<0,05) decrease in the intensity of the pain syndrome at the 2nd session.Conclusion. In order to increase the effectiveness of treatment, osteopathic correction of somatic dysfunctions in patients with dorsopathy at the cervicothoracic level can be supplemented with complex kinesitherapy, both in the form of traditional exercise therapy, and in the form of special exercises for correction of altered motor stereotype.

scholarly journals Surgical treatment of Dunbar syndrome

2013 ◽  
Vol 12 (1) ◽  
pp. 57-61 ◽  
Author(s):  
Luís Henrique Gil França ◽  
Carla Mottin
Keyword(s):  
Clinical Condition ◽  
Epigastric Pain ◽  
Celiac Trunk ◽  
Celiac Artery ◽  
Transluminal Angioplasty ◽  
Celiac Artery Compression Syndrome ◽  
Extrinsic Compression ◽  
Arcuate Ligament ◽  
Dunbar Syndrome ◽  
Angioplasty And Stenting

Dunbar syndrome or celiac artery compression syndrome is an infrequently described clinical condition with poorly defined diagnostic criteria and an obscure pathophysiology. It is usually associated with an extrinsic compression upon the celiac axis near its takeoff from the aorta by fibrous diaphragmatic bands or sympathetic neural fibers. The authors report the case of a 70-year-old male patient presenting with nausea, epigastric pain, and weight loss. An aortography showed a compression of the celiac trunk. A preliminary attempt at percutaneous transluminal angioplasty and stenting proved unsuccessful. The patient became asymptomatic and his clinical condition improved after surgical release of the celiac trunk by partial section of the arcuate ligament of the diaphragm and with resection of the neural, fibrotic, and lymphatic tissues surrounding the aortic and visceral vessels. The purpose of this report is to discuss the indications and the therapeutic options of this syndrome.

CLINICAL CASE OF SUCCESSFUL MANAGEMENT OF PREGNANCY AND CHILDBIRTH IN A PATIENT WITH PERIPHERAL NERVOUS SYSTEM PATHOLOGY

2021 ◽  
Vol 2 (1) ◽  
pp. 42-47
Keyword(s):  
Nervous System ◽  
Pregnant Woman ◽  
Peripheral Nervous System ◽  
Clinical Case ◽  
Test Preparation ◽  
Pain Syndrome ◽  
Delivery Method ◽  
Successful Management ◽  
Pregnancy And Childbirth ◽  
Joint Management

The purpose of our study was to study the case of successful management of pregnancy and childbirth in patient K., 39 years old with pathology of the peripheral nervous system: spinal stenosis L5 – S1, herniated L5-S1, surgery in 2014 (hemilaminectomy L5-S1, disc resection L5-S1), vertebrogenic pain syndrome. At the stage of pre-test preparation and during pregnancy, she is consulted by a neurologist to determine the tactics of pregnancy and childbirth management. Rational pregnancy planning, joint management of a pregnant woman by an obstetrician-gynecologist and a neurologist allowed choosing the optimal pregnancy management tactics and delivery method.

Bladder pain syndrome

2017 ◽  
Author(s):  
Magnus Fall
Keyword(s):  
Treatment Options ◽  
Correct Diagnosis ◽  
Pain Syndrome ◽  
Bladder Pain Syndrome ◽  
Clinical Syndrome ◽  
Personal Life ◽  
Medical Community ◽  
Bladder Pain ◽  
Profound Impact ◽  
Medical Consultations

Bladder pain syndrome has a profound impact on the patients’ physical, professional, and personal life. Generally, recognition of this clinical syndrome is hampered by insufficient expertise in the medical community. The correct diagnosis is often delayed by several years and may be preceded by multiple medical consultations and treatment attempts. Still, this is one of the most painful, non-malignant conditions to be encountered in urology and it is probably more common than generally believed. Problems as to diagnosis, phenotyping, terminology, and management persist, but during the last few years there has been increasing activity to resolve those issues. In this chapter, symptoms, findings, and treatment options are outlined.

Chronic abdominal pain as a manifestation of congenital compressional stenosis of the celiac trunk in children: world and own experience

2020 ◽  
Vol 15 (4) ◽  
pp. 62-68
Author(s):  
R.A. Zainulabidov ◽  
◽  
A.Yu. Razumovsky ◽  
A.I. Khavkin ◽  
◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Lymph Nodes ◽  
Congenital Abnormality ◽  
Celiac Trunk ◽  
Chronic Abdominal Pain ◽  
Median Arcuate Ligament ◽  
Modern Methods ◽  
Arcuate Ligament ◽  
Dunbar Syndrome ◽  
Methods Of Treatment

Celiac trunk compression stenosis or Dunbar's syndrome, characterized by chronic abdominal pain, is a congenital abnormality based on compression of the celiac trunk by the inner legs of the median arcuate ligament of the diaphragm and neurofibrous tissue of the celiac plexus. In the overwhelming majority of cases, Dunbar's syndrome is a congenital malformation, but variants of compression of the celiac trunk by enlarged lymph nodes are also possible and is considered an acquired disease. The review considers modern methods of treatment of Dunbar syndrome in children and the supervision of this group of patients. Key words: Compression celiac trunk stenosis in children, Dunbar syndrome, median arcuate ligament tsyndrome

scholarly journals Integrated Rehabilitation after a Cranial Brain Injury in the Conditions of a Sanatorium with Application of Barotherapy (Description of a Clinical Case)

2020 ◽  
Vol 100 (6) ◽  
pp. 120-129
Author(s):  
E.A. Guryanova ◽  
T.V. Chernova ◽  
O.A. Tihoplav
Keyword(s):  
Brain Injury ◽  
Clinical Case ◽  
Communication Disorders ◽  
Functional Restoration ◽  
Medical Rehabilitation ◽  
Dynamic Monitoring ◽  
International Classification Of Functioning ◽  
Medical Community ◽  
Speech Impairment ◽  
Massage Therapist

Restoration after injuries is one of the key issues of medical rehabilitation practice. In the cases of severe traumatic brain injury, treatment and rehabilitation does not fit ordinary guidelines, and implementation of wider range of medical and rehabilitation technologies is necessary. In the case of a successful result in the rehabilitation process a clinical analysis of individual clinical examples is important for the medical community. The article presents the clinical case of the patient suffering from severe consequences of a head injury,in the form of severe speech impairment, paresis, communication disorders, and social maladaptation of the patient. The patient received a long-term stage rehabilitation in an in-patient department, composed of 5 treatment courses, during 11–12 days, lasting fora year. The rehabilitations courses included: pharmacotherapy, physiotherapeutic procedures, massage, acupuncture, physical therapy exercises individually with an instructor, barotherapy, etc. Rehabilitation had been carried out in the rehabilitation department by a multidisciplinary team, including neurologist, reflexologist, physiotherapist, physical rehabilitation specialist, occupational therapist,speech therapist, massage therapist and nurses. These specialists were trained during the implementation of the Pilot Project for the Development of Medical Rehabilitation in the Russian Federation in 2016. The dynamic monitoring of functional restoration within the framework of rehabilitation was performed using the International Classification of Functioning, as it reflects the state of health and disorders individually for the patient and estimate these indicators universally, where none of the functional disorders is a priority, and allows rehabilitation measures to be carried out more complex. The result was: increase in strength and functional capabilities of certain muscle groups, improved swallowing and voice formation and restoration of the minimal communicative capabilities in the sphere of social functioning.

scholarly journals Endovascular Treatment of Mesenteric Ischaemia

2019 ◽  
Vol 9 (3) ◽  
pp. 239-241
Author(s):  
M. O. Loginov ◽  
L. S. Kokov ◽  
M. A. Nartaylakov ◽  
N. R. Chernaya ◽  
M. V. Loginova
Keyword(s):  
Endovascular Treatment ◽  
Clinical Case ◽  
Celiac Trunk ◽  
Transluminal Angioplasty ◽  
Mesenteric Arteries ◽  
Mesenteric Ischaemia ◽  
Visceral Arteries ◽  
Internal Iliac ◽  
Angioplasty And Stenting ◽  
Percutaneous Transluminal

Chronic mesenteric ischaemia constitutes a condition characterised by a decreased abdominal blood flow, which is caused by the obstruction of visceral arteries. This short communication paper presents a clinical case of endovascular treatment in a patient with the obstruction of the celiac trunk, superior and inferior mesenteric arteries. Intestinal blood supply was provided through collaterals from the system of internal iliac veins via the inferior mesenteric artery, the arc of Riolan. This clinical case confirmed that percutaneous transluminal angioplasty and stenting of the visceral arteries is the method of choice in the surgical treatment of abdominal angina.

scholarly journals Multi-stage treatment of non-specific spondylodiscitis of the cervical spine

2021 ◽  
Vol 23 (2) ◽  
pp. 93-102
Author(s):  
A. V. Sytnik ◽  
V. N. Obolenskiy ◽  
I. S. Lvov ◽  
A. Yu. Kordonskiy ◽  
S. A. Rozhanskiy
Keyword(s):  
Cervical Spine ◽  
Antibacterial Therapy ◽  
Clinical Case ◽  
Pain Syndrome ◽  
Bone Block ◽  
Complete Regression ◽  
Titanium Plate ◽  
Spinal Root ◽  
Paravertebral Abscess ◽  
Halo Device

The objective is to present a clinical case of successful treatment of a patient with recurrent spondylitis at the cervical level.Clinical case. A 65-year-old patient was diagnosed with purulent spondylodiscitis at the level of C6-C7 vertebrae with the epidural and paravertebral abscesses and spinal cord compression. Emergency left colotomy, paravertebral abscess dissection, corporectomy of the C6 vertebra, abscess removal, anterior spondylodesis with bone autograft and titanium plate were performed. Massive antibacterial therapy was prescribed. After the operation, the volume of movement in the left limbs was restored, and on the 15th day after the operation, the patient was discharged. On the 36th day after discharge, she was hospitalized again with hematuria. A recurrence of suppuration in the area of the operation and phlegmon of both feet was revealed. Revision of the surgical wound and rehabilitation of the purulent focus on the neck, surgical intervention for phlegmon were performed. In purulent foci, Staphylococcus aureus was verified, which is sensitive to the main antibacterial drugs. Antibacterial therapy was continued, then, after changing the microflora in the wound, other antibiotics were prescribed. There was a pain in the area of the left spinal root C5. The connection of the fistula course with the titanium plate, the increase of pathological kyphosis at the level of the overlying vertebrae was found. The wound was examined, the titanium plate was removed, and the halo device was applied to correct the pathological kyphosis. After the operation, the radicular pain syndrome regressed, and the axis of the cervical spine was restored. After 1 month, the posterior combined fixation of the cervical spine at the C3-Th7 level was performed, and the halo device was dismantled. After 6 months, the patient was stopped wearing the Philadelphia neck collar, no recurrence of suppuration was observed, and a complete regression of neurological disorders was noted. After 1 year, a complete bone block is preserved between the C4-C7 vertebrae.Conclusion. The presented clinical case clearly illustrates the complexity of managing patients with inflammatory diseases of the cervical spine. Currently, there is no single treatment strategy for patients with spondylitis.

scholarly journals Celiac trunk compression syndrome: modern ideas about the problem (review of literature)

2021 ◽  
Vol 27 (3) ◽  
pp. 23-28
Author(s):  
Z. M. Khamid ◽  
D. I. Vasilevsky ◽  
A. Yu. Korolkov ◽  
S. G. Balandov
Keyword(s):  
Minimally Invasive ◽  
Pathological Condition ◽  
Clinical Manifestations ◽  
Pain Syndrome ◽  
Celiac Trunk ◽  
Vascular Reconstruction ◽  
Compression Syndrome ◽  
Minimally Invasive Surgical ◽  
Minimal Trauma ◽  
Visceral Arteries

Celiac trunk compression syndrome is a symptom complex arising from compression of the celiac trunk by the median arcuate ligament, crura of diaphragm or ganglion tissue of the celiac plexus. The main clinical manifestations of this pathological condition are abdominal pain syndrome, indigestion and weight loss. The disease is detected in 0.4–1 % of people in the population, more often in young people. The pathophysiological mechanisms of the development of celiac trunk compression syndrome remain not fully understood, but the key reason for its development is ischemia of the digestive system. The main instrumental methods for diagnosing compression of the celiac trunk are ultrasound duplex scanning of the abdominal aorta and visceral arteries and spiral computed angiography. The only effective treatment for celiac trunk compression syndrome is surgery. Currently, both classical techniques and various minimally invasive technologies are used to decompress the celiac trunk. The advantages of open access include good visual and manual control of anatomical structures, the possibility of eliminating complications, changing the tactics of surgical intervention, if necessary, performing vascular reconstruction. The advantage of minimally invasive surgical technologies is minimal trauma to the abdominal wall tissues, minor postoperative pain syndrome, early rehabilitation, a low risk of developing cusp, wound infection and hernial defects. Regardless of the methodology, surgical treatment can achieve a positive effect in 75–90 % of patients with celiac trunk compression syndrome. These are the modern concepts of epidemiology, pathogenesis, clinical manifestations, diagnosis and methods of treatment of this pathological condition.

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