scholarly journals The analysis of the clinical case in the stepped treatment of multiple choledocholithiasis and locally advanced kidney cancer

2021 ◽  
Author(s):  
N. S. Novruzbekov ◽  
R. M. Nagaev ◽  
I. V. Yangirov ◽  
G. A. Starkov ◽  
G. A. Gasanbekov ◽  
...  
Keyword(s):  
Kidney Cancer ◽  
Clinical Case ◽  
Locally Advanced ◽  
Clinical Manifestations ◽  
Second Stage ◽  
Staged Surgery ◽  
Single Block ◽  
The Right ◽  
Angiography And Embolization ◽  
Successful Observation

This article is devoted to the analysis of the clinical case which includes the clinical manifestations and treatment of multiple choledocholithiasis and locally advanced kidney cancer. A staged surgery was performed. Retrograde papillosphincterotomy with cholechocholitholite extraction was done at the first stage. The second stage includes laparotomy, removal of the tumor of the right kidney / adrenal gland as a single block, cholecystectomy after preliminary angiography and embolization of the vessels feeding the tumor. The presented successful observation demonstrates one of the modern approaches in the treatment of patients with comorbid pathology.

scholarly journals Surgical treatment of a patient with combined lesion of the coronary and carotid arterial systems

2021 ◽  
pp. 21-28
Author(s):  
V. Yu. Ridel ◽  
K. M. Mikhailov ◽  
M. D. Sentsova ◽  
N. M. Mikhailov
Keyword(s):  
Coronary Artery ◽  
Surgical Treatment ◽  
Clinical Case ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
Second Stage ◽  
Staged Surgery ◽  
Combined Lesions ◽  
Carotid Arterial ◽  
Vessel Coronary Artery

A clinical case of surgical treatment of a patient with atherosclerotic combined lesions of the coronary and carotid areas is presented. A staged surgery was performed. The first stage was carotid endarterectomy sequentially on both sides. The second stage is three-vessel coronary artery bypass grafting. The patient was examined 2 years after the operation. There are no data on restenosis of the reconstruction zone of the carotid system. The return of angina pectoris is not noted.

scholarly journals Surgical management of a patient with biliodigestive anastomosis stricture complicated by multiple intrahepatic lithiasis

2021 ◽  
Vol 180 (4) ◽  
pp. 82-85
Author(s):  
A. Yu. Korolkov ◽  
D. N. Popov ◽  
A. O. Tantsev ◽  
T. O. Nikitina ◽  
S. F. Bagnenko
Keyword(s):  
Small Bowel ◽  
Surgical Management ◽  
Clinical Case ◽  
Surgical Intervention ◽  
Biliodigestive Anastomosis ◽  
Second Stage ◽  
Intrahepatic Lithiasis ◽  
Iatrogenic Damage ◽  
The Right ◽  
Upper Abdomen

A clinical case of surgical management of patient with biliodigestive anastomosis stricture complicated by multiple intrahepatic lithiasis is presented. The patient was 57 years old woman. Anamnesis of the disease: in 2016, biliodigestive anastomosis was performed due to iatrogenic damage of the biliary tract. She was admitted to the hospital with complaints of the right upper abdomen pain, accompanied by chills, jaundice, and fever up to 39°C. The examination revealed a stricture of a previously formed biliodigestive anastomosis complicated by multiple intrahepatic cholelithiasis. Surgical intervention was performed: at the first stage – percutaneous transhepatic cholangiostomy; at the second stage – laparotomy, separation of hepaticojejunoanastomosis, intraoperative cholangioscopy with lithoextraction, resection of a small bowel section with a Brownian anastomosis, post-colon hepaticojejunostomy on a disconnected loop and replaceable transhepatic drains (Smith-Praden-Saypol-Kurian).

scholarly journals Renal Cancer with Tumor Thrombus of the Inferior Vena Cava and the Right Atrium

2020 ◽  
Vol 13 (3) ◽  
pp. 214-226
Author(s):  
Yulia Aleksandrovna Stepanova ◽  
Aleksandr Anatolevich Gritskevch ◽  
Amiran Shotaevich Revishvili ◽  
Madina Valerevna Kadirova ◽  
Egor Sergeyevich Malyshenko ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Inferior Vena Cava ◽  
Kidney Cancer ◽  
Right Atrium ◽  
Tumor Thrombus ◽  
Clinical Case ◽  
Inferior Vena ◽  
Vena Cava ◽  
Radical Treatment ◽  
The Right

ntroduction. A distinctive feature of kidney cancer is a frequent, compared with other tumors, spread of the tumor through the venous collectors (in the renal and inferior vena cava up to the right atrium), along the path of least resistance to invasive growth.The aim of the study was to present a clinical case of radical treatment of kidney cancer involving extensive IVC thrombosis.Materials and methods. The study describes a clinical case of radical treatment of patient M. with kidney cancer involving extensive IVC thrombosis, extending to the right atrium (written informed consent for patient information and images to be published was obtained prior to the study). During preoperative examination, the patient was diagnosed with renal cell carcinoma with non-occlusive hypervascular tumor thrombus of the renal vein, the inferior vena cava and the right atrium based on the findings of ultrasound examination (transabdominal and transthoracic, and transesophageal), multislice computed tomography (MSCT) and magnetic resonance imaging (MRI).Results and discussion. Surgical treatment remains the main method of treatment of renal cell cancer, moreover, the inferior vena cava thrombosis cannot serve as a cause for refusing surgical treatment. The thrombus spreading along the venous collectors is an important factor in determining the tactics of surgical treatment. The length of the tumor thrombus, as well as the degree of its fixation and ingrowth into the vein wall is of great significance for planning surgical techniques and predicting clinical outcomes. Based on various methods of radiological examination, patient M. was diagnosed with cancer of the right kidney, 3 stage T3cNxM0, IVC tumor thrombus, paraneoplastic syndrome (hyperthermia), right-sided nephrectomy with aortocaval lymphadenectomy, thrombectomy from the IVC, vascular isolation of the liver, resection of the IVC, thrombectomy from the right atrium combined with cardiopulmonary bypass.Conclusion. Despite the technical complexity of nephrectomy with thrombectomy from the IVC, especially in the presence of a massive supradiaphragmatic thrombus, these interventions have no alternatives if a radical treatment is to be achieved. Step-by-step support using radiological methods of investigation is an important aspect of patients preparation; this allowing determining the exact volume of the damage and non-invasively assessing clinical outcomes of surgical treatment.

scholarly journals Q-wave myocardial infarction of lower left ventricular in a female patient in the early postoperative period after lung resection due to tuberculoma

2020 ◽  
Vol 98 (4) ◽  
pp. 53-57
Author(s):  
V. L. Dobin ◽  
A. N. Nikolaev ◽  
N. A. Аrkhipochkina ◽  
M. A. Muravieva ◽  
L. M. Kryukova
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Female Patient ◽  
Postoperative Period ◽  
Clinical Case ◽  
Lung Resection ◽  
Clinical Manifestations ◽  
Left Ventricular ◽  
Early Postoperative Period ◽  
The Right

The article presents a clinical case of myocardial infarction in the early postoperative period after lung resection due to tuberculosis in a 51-year-old patient; clinical manifestations, diagnosis, management tactics and successful treatment are described. In 24 hours after the diagnosis was made, the patient underwent emergency stenting of the right coronary artery in the cardiologic dispensary.The authors state that they have no conflict of interests.

scholarly journals Heart transplantation in a patient with primary malignant tumor

2019 ◽  
Vol 21 (1) ◽  
pp. 77-81
Author(s):  
E. E. Kliver ◽  
I. S. Murashov ◽  
A. M. Volkov ◽  
E. N. Kliver ◽  
D. V. Doronin
Keyword(s):  
Ventricular Tachycardia ◽  
Right Ventricle ◽  
Clinical Case ◽  
Malignant Tumors ◽  
Clinical Manifestations ◽  
Apical Region ◽  
Rf Ablation ◽  
Life Threatening ◽  
Electrophysiological Examination ◽  
The Right

The article looks at a clinical case of a 31-year-old female with signs of paroxysmal ventricular tachycardia and Morgagni–Adams–Stokes syndrome. In April 2014, electrophysiological examination revealed a source of ventricular tachycardia localized in the apices of the right and left ventricles of the patient. The sources were then subjected to RF ablation followed by cardioverter-defibrillator implantation. Subsequent antiarrhythmic therapy failed to improve her state. In September 2016 the patient was re-examined and underwent RF ablation of the apical region of the right ventricle. Later on, taking into account continuously recurrent life-threatening cardiac rhythm disorders, as well as unpromising strategies for further conservative treatment, she was put on the waiting list and then underwent orthotopic cardiac transplantation. Histological examination and immunohistochemistry assay showed leiomyosarcoma in the source of ventricular tachycardia previously found in the apex of the right ventricle. This clinical case demonstrates a diversity of clinical manifestations of primary malignant tumors of the heart that pose a challenge for intravital diagnostics and interpretation of a clinical picture.

scholarly journals A clinical case of metastatic osteosarcoma in the heart cavity

2018 ◽  
Vol 22 (1) ◽  
pp. 55
Author(s):  
E. I. Iofe ◽  
V. G. Konov ◽  
E. B. Solovyev ◽  
I. I. Bridun
Keyword(s):  
Conflict Of Interest ◽  
Right Atrium ◽  
Clinical Case ◽  
Vascular System ◽  
Heart Diseases ◽  
Clinical Manifestations ◽  
Pericardial Patch ◽  
Metastatic Osteosarcoma ◽  
Malignant Lesions ◽  
The Right

<p>Tumors of the heart are catalogued as a poorly studied area of clinical oncology because of an extreme rarity of this pathology, absence of pathognomonic symptoms, a large variety of clinical manifestations, and diagnostic complexity. In order to achieve diagnostic and therapeutic adequacy, clinicians need to be aware of cancer heart diseases and their frequently atypical clinical manifestations. The report presents a clinical case of tumor spreading through the vascular system and malignant lesions of the right atrium of the heart in a patient with osteosarcoma of the humerus, where osteosarcoma metastases are resected and plasty of the right atrium is performed by using a pericardial patch.</p><p>Received 22 August 2017. Revised 7 December 2017. Accepted 11 December 2017.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p>

scholarly journals A clinical case of bronchoscopic detection and removal of a foreign body from the upper lobar bronchus on the right mimicking lung cancer

2020 ◽  
Vol 98 (8) ◽  
pp. 58-62
Author(s):  
L. V. Telegina ◽  
S. S. Pirogov ◽  
T. I.-A. Tazabaev ◽  
V. E. Khoronenko ◽  
A. S. Vodoleev ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Foreign Body ◽  
Clinical Case ◽  
Foreign Bodies ◽  
Clinical Manifestations ◽  
Cigarette Filter ◽  
X Ray ◽  
Lobar Bronchus ◽  
Long Time ◽  
The Right

Foreign bodies in the respiratory tract are rare in adults. Clinical manifestations include hemoptysis among other signs which requires the examination to detect tuberculosis and lung cancer. The article describes a clinical case that demonstrates the possibilities of endoscopic diagnostics and treatment in the patient with an X-ray negative foreign body (a cigarette filter) that has been in the lumen of the upper lobar bronchus of the right lung for a long time which caused inflammation in the blocked lobe and mimicking endoscopically central lung cancer.

Clinical case of lung lesions in patient with newly diagnosed systemic lupus erythematosus

2019 ◽  
Vol 1 (9) ◽  
pp. 53-57
Author(s):  
T. N. Gavva ◽  
L. V. Kuzmenkova ◽  
Yu. N. Fedulaev ◽  
T. V. Pinchuk ◽  
D. D. Kaminer ◽  
...  
Keyword(s):  
Systemic Lupus Erythematosus ◽  
Lupus Erythematosus ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Lung Damage ◽  
Newly Diagnosed ◽  
Systemic Lupus ◽  
Lung Lesions ◽  
Laboratory Parameters ◽  
Clinical Interest

A case of lung damage in systemic lupus erythematosus (SLE) in a 33-year-old woman is described. This case is of clinical interest due to the complexity of diagnosis due to the fact that SLE is a disease with diverse clinical manifestations involving many organs and systems, which often makes it difficult to timely recognize the onset of the disease. SLE still remains a challenge and requires special attention to the patient s history, clinical and laboratory parameters of the patient, as well as specific immunological examinations.

Combined Extended High Spinal Anesthesia and Endotracheal Narcosis: a Clinical Case

2019 ◽  
Vol 4 (2) ◽  
pp. 152-154
Author(s):  
A. B. Yakushevsky ◽  
A. N. Plekhanov ◽  
A. B. Ayusheev
Keyword(s):  
Abdominal Surgery ◽  
Spinal Anesthesia ◽  
Postoperative Period ◽  
Initial Dose ◽  
Clinical Case ◽  
Central Hemodynamics ◽  
Narcotic Analgesics ◽  
Spinal Catheter ◽  
The Right ◽  
Endotracheal Anesthesia

Background. In recent years, various methods of combined anesthesia during abdominal surgery have been introduced into clinical practice.Aim. To demonstrate the possibilities of a combination of high prolonged spinal anesthesia and endotracheal anesthesia during abdominal surgery.Materials and methods. A clinical case of combined use of high prolonged spinal anesthesia and endotracheal anesthesia in a 48-year-old patient with a tumor in the right half of the ascending part of the right half of the colon is presented.Results. The patient received a puncture of the spinal space at a standard point and was installed a spinal catheter in the cranial direction for 3 cm. An isobaric solution of marcaine in the initial dose of 20 mg was injected into the catheter. The regulation of the development of the block was regulated by the inclination of the head end of the table by 60°. After that endotracheal anesthesia was performed on the basis of fentanyl and propofol. This combination allowed to expand the scope of surgical intervention, provided adequate pain relief intraoperatively and in the postoperative period, without the use of narcotic analgesics. With the appearance of signs of recovery of pain sensitivity, intraoperatively or in the postoperative period, re-introduction of the anesthetic into the spinal catheter was performed in half of the initial dose with liquor barbotage. In the early postoperative period, the patient was on strict bed rest with a head end of the bed raised at 30–45°. The method provides complete segmental blockade and muscle relaxation in the area of operation, stability of central hemodynamics during surgery and in the postoperative period.Conclusion. This type of anesthesia is more easily tolerated by patients, accompanied by early awakening and extubation, characterized by stability of central hemodynamics, reduced risk of complications, the possibility of prolonging anesthesia with lower doses of narcotic analgesics in the intraoperative period, providing high-quality anesthesia in the postoperative period without resorting to the use of narcotic analgesics.

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