scholarly journals A CLINICAL CASE OF SURGICAL TREATMENT OF PEPTIC ULCER OF GASTROENTEROANASTOMOSIS

2021 ◽  
Vol 9 (1) ◽  
pp. 101-106
Author(s):  
S.V. Leonchenko ◽  
◽  
V.N. Petyushkin ◽  
A.P. Motin ◽  
A.A. Dyomin ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Surgical Treatment ◽  
Clinical Case ◽  
Abdominal Cavity ◽  
Decisive Role ◽  
Pain Syndrome ◽  
Gastric Surgery ◽  
Early Postoperative Period ◽  
Actual Problem ◽  
Long Time

In the article a clinical case of surgical treatment of peptic ulcer of gastroenteroanastomosis complicated with perforation and gastrointestinal bleeding, is described. The patient was observed with the diagnosis: cholelithiasis, chronic calculous cholecystitis, for which planned laparoscopic cholecystectomy with draining of the abdominal cavity was performed. According to the discharge record, the operation ran without peculiarities. Later the patient was rehospitalized with complaints of weakness, nausea, vomiting, pain in the upper parts of the abdomen; he was diagnosed with ulcer of gastroenteroanastomosis and continuing bleeding that were indications for the surgical intervention for life-saving indications. From the patient words, a part of the stomach was resected more than 20 years before for gastric ulcer. Until the latest time, the patient felt satisfactory, but within 6 months pain in the abdomen reappeared, however, on examination cholelithiasis was identified, and the pain syndrome was attributed to this pathology. Assumably, after the first operation performed in 1995, a complication developed in the early postoperative period in the form of obstruction of gastroenteroanastomosis (anastomositis?), and additional gastroenteroanastomosis was applied. Conclusion. Peptic ulcer of anastomosis is an actual problem of the gastric surgery which may not only appear long time after the operation, but may give the same complications as «essential» peptic ulcer, and really threaten the life of patients. It should be noted that in some cases the intraoperative picture, experience and sensations of a surgeon play a decisive role in the diagnosis of surgical pathology even if they differ from the data of additional methods of examination.

scholarly journals Minimum Invasive Stabilizing and Decompressive-Stabilizing Methods of Surgical Treatment for Degenerative-Dystrophic Lesions of Spine

2011 ◽  
Vol 18 (4) ◽  
pp. 3-10
Author(s):  
A V Krut'ko ◽  
Shamil' Al'firovich Akhmet'yanov ◽  
D M Kozlov ◽  
A V Peleganchuk ◽  
A V Bulatov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Surgical Techniques ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Surgical Interventions ◽  
Comparative Group ◽  
Operative Wound

Results of randomized prospective study with participation of 94 patients aged from 20 to 70 years with monosegmental lumbar spine lesions are presented. Minimum invasive surgical interventions were performed in 55 patients from the main group. Control group consisted of 39 patients in whom decompressive-stabilizing operations via conventional posteromedian approach with skeletization of posterior segments of vertebral column were performed. Average size of operative wound in open interventions more than 10 times exceeded that size in minimum invasive interventions and made up 484 ± 56 and 36 ± 12 sq.cm, respectively. Mean blood loss was 326.6 ± 278.0 ml in the main group and 855.1 ± 512.0 ml in the comparative one. In the main group no one patient required substitution hemotransfusion, while in 13 patients from the comparative group donor erythrocytic mass and/or fresh-frozen plasma were used to eliminate the deficit of blood components. Intensity of pain syndrome in the zone of surgical intervention by visual analog scale in the main group was lower than in comparative group. In the main and comparative groups the duration of hospitalization made up 6.1 ± 2.7 and 9.7 ± 3.7 bed days, respectively. In no one patient from the main group complications in the zone of operative wound were noted. Three patients from the comparative group required secondary debridement and in 1 patient early deep operative wound suppuration was observed. Application of low invasive surgical techniques for the treatment of patients with degenerative lumbar spine lesions enabled to perform radical surgical treatment with minimal iatrogenic injury. The method possessed indubitable advantages over the conventional open operations especially intraoperatively and in early postoperative period.

scholarly journals MIGRATION OF THE INTRAUTERINE DEVICE TO THE ABDOMINAL CAVITY

2017 ◽  
Vol 25 (2) ◽  
pp. 247-262
Author(s):  
D. A. Rahmonov ◽  
F. Sh. Rashidov ◽  
E. L. Kalmykov ◽  
M. M. Marizoeva ◽  
O. B. Bobdjonova ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Intrauterine Device ◽  
Abdominal Cavity ◽  
Clinical Signs ◽  
Uterine Cavity ◽  
Pain Syndrome ◽  
Pregnant Patient ◽  
Pelvic Cavity ◽  
And Migration ◽  
Laparoscopic Removal

The aim: demonstration of our experience of surgical treatment of patients with migrated intrauterine device (IUD) into the abdominal cavity. The results of surgical treatment of migrated IUDs in the pelvic cavity are summarized in 17 women. The average age of the patients was 33,23,4 years. The timing of implantation of the IUDs varied from 10 days to 24 months. In all cases, the intra operational finding was T-shaped a copper device. The reason behind the women's consultation was an increase in pain syndrome in the lesser pelvis (n=15), dysuric phenomenon (n=1) and the onset of pregnancy (n=1). Perforation of the uterus and migration of the spiral occurred from 10 days to 2 years after its implantation. All patients were operated laparoscopicaly. The average duration of operations was 45,510,5 minutes. In the postoperative period there were no complications from the pelvic organs and postoperative wounds. The period of hospitalization of patients was 3,50,7 days. In all cases there was a regression of clinical signs and recovery. In one pregnant patient (gestation period 5-6 weeks) the pregnancy proceeded without particular pathological abnormalities and resulted in the birth of a full-term child. Laparoscopic removal of the IUD migrating from the uterine cavity to the abdominal cavity is the method of choice in the treatment of this group of patients, avoiding development of intra- and postoperative complications and a shorter length of stay in the hospital. The effectiveness of the procedure reaches 100%. The most common cause of complication of the IUD is the perforation of the uterus during its implantation.

scholarly journals Perforated Peptic Ulcer Combined with Posttraumatic Diaphragmatic Hernia in Third Gestation Trimester: a Clinical Case

2021 ◽  
Vol 11 (3) ◽  
pp. 251-255
Author(s):  
V. S. Panteleev ◽  
I. B. Fatkullina ◽  
A. Kh. Mustafin ◽  
R. S. Khalitova ◽  
A. S. Petrov
Keyword(s):  
Peptic Ulcer ◽  
Pregnant Women ◽  
Diaphragmatic Hernia ◽  
Clinical Case ◽  
Abdominal Cavity ◽  
Perforated Peptic Ulcer ◽  
Favourable Outcome ◽  
Duodenal Perforation ◽  
Duodenal Ulcers ◽  
In Pregnancy

Background. Gastric and duodenal ulcers are extremely rare in pregnancy, according to published literature. Peptic ulcer is found in 1 per 4,000 pregnant women, a figure probably underestimated due to its hampered diagnosis in pregnancy. Pregnancy peptic ulcer is considered less expected. Perforated gastric and duodenal ulcers comprise about 1.5 % of total acute abdominal diseases, and the perforation rate in ulcer patients ranges within 5–15 %. This complication afflicts the ages of 20–40 years in men much more frequently than in women. Three perforation types occur: free into abdominal cavity (87 %), contained (9 %), into lesser omentum and retroperitoneal tissue (4 %).Materials and methods. The clinical case describes surgical management of posttraumatic diaphragmatic hernia-comorbid perforated gastric ulcer in a pregnant woman in third trimester. Surgery with postoperative patient management enabled for a favourable outcome.Results and discussion. Perforation-entailing gastric and duodenal ulcers in pregnant women have received negligible attention due to rarity in clinical practice. Paul et al. described 14 cases of duodenal perforation in pregnancy, all fatal.Conclusion. Early diagnosis of surgical pathology during gestation is still difficult contributing to the development of severe complications associated with high mortality. The patient’s admission to a level III interspecialty hospital was key to enable a timely consilium-driven decision of caesarean intervention for saving the child, diagnosing intraoperatively life-threatening complicated surgical diseases and opting for radical surgery that ended in a favourable outcome.

Surgical treatment of the consequences of a gunshot wound to the lumbar spine using endoscopic techniques

2021 ◽  
Vol 23 (2) ◽  
pp. 91-98
Author(s):  
Gennady G. Bulyschenko ◽  
Alexey I. Gayvoronsky ◽  
Pavel S. Liev ◽  
Mikhail V. Kuznetsov ◽  
Dmitry V. Svistov
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Foreign Body ◽  
Endoscopic Surgery ◽  
Gunshot Wound ◽  
Clinical Case ◽  
Decisive Role ◽  
Endoscopic Techniques ◽  
Surgical Tactics ◽  
Transforaminal Endoscopic Surgery

A clinical case of treatment of a patient with long-term consequences of a gunshot wound to the lumbar spine with a follow-up period of fifteen years is presented. In the last year and a half, the repeatedly recurrent retroperitoneal phlegmon associated with a foreign body of the lumbar spine has prompted a decision on the issue of surgical treatment (removal of a foreign body - a bullet). The location of the foreign body and previous experience with endoscopic foreign body removal played a decisive role in the choice of surgical tactics. Removal of the wounding projectile was performed using a percutaneous transforaminal endoscopic approach. The choice of such an approach was dictated by the peculiarity of the location of the foreign body (coaxial with the endoscopic tube in the foraminal approach), as well as sufficient experience in using the technique of percutaneous endoscopic surgery. At the same time, the conversion plan was worked out in sufficient detail with both posterolateral and anterior open approaches with the involvement of appropriate specialists. So, in case of failure, it was planned to transfer endoscopic access to open, using the already installed working tube of the endoscope as a conductor to a foreign body. In case of inefficiency, for some reason, this version of the operation was planned for the next, third stage: wound suturing, patient turning on the back with a right-hand retroperitoneal approach to the anterior-lateral surface of LI and LII bodies. Fortunately, the purpose of the operation was achieved using the most gentle version of the allowance. The given clinical case testifies that the technique of percutaneous transforaminal endoscopic surgery is not limited in indications to the treatment of degenerative-dystrophic diseases of the spine.

scholarly journals Low-intensity low-frequency magnetotherapy in the early postoperative period in patients with breast cancer

2020 ◽  
Vol 17 (5) ◽  
pp. 233-240
Author(s):  
Inna S. Evstigneeva ◽  
Marina Yu. Gerasimenko
Keyword(s):  
Breast Cancer ◽  
Surgical Treatment ◽  
Upper Limb ◽  
Low Frequency ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Advanced Technique ◽  
Low Intensity ◽  
Extended Technique

Background. Rehabilitation of patients after radical treatment of breast cancer is especially relevant due to the fact that successes in diagnostics and treatment of this disease in recent years have led to an increase in the life expectancy of female patients. Aim. to compare the efficiency of various methods of low-frequency low-intensity magnetotherapy in patients operated on for breast cancer, in the early terms (24 days) after surgery. Methods. Objective and instrumental examination was performed in 78 patients after radical surgical treatment of breast cancer in the early stages (24 days) after surgery. All patients received a course of low-frequency low-intensity magnetotherapy. Results. When applying the extended technique (the effect on the segmental-reflex region and upper limb from the side of the surgery), patients noted an improvement in the quality of life, a decrease in swelling of the upper limb, and a decrease in pain syndrome. A decrease in the number of postoperative complications and the duration of lymphorrhea was noted. Conclusion. Thus, the use of various methods of low-frequency low-intensity magnetotherapy is advisable to use in the early terms (24 days) after surgical treatment, however, the use of the advanced technique provides high function capabilities and enables to get a more pronounced and lasting clinical result.

scholarly journals Omentum lymphangioma in a child

2020 ◽  
Vol 174 (5) ◽  
pp. 99-103
Author(s):  
A. V. Nikitin ◽  
A. I. Khavkin ◽  
T. A. Skvortsova ◽  
G. V. Volynets ◽  
A. O. Atameeva
Keyword(s):  
Clinical Case ◽  
Abdominal Cavity ◽  
Open Laparoscopy ◽  
Long Time

The article presents a clinical case of omentum lymphangioma in a child, which was successfully resected by open laparoscopy. This clinical case indicates the need for caution in relation to tumors of the abdominal cavity, which for a long time can occur against the background of nonspecifi c complaints or asymptomatically, and also shows positive dynamics against the background of the therapy.

scholarly journals COMPARISON OF DIAGNOSTIC METHODS AND TREATMENT OF ENDOMETRIOSIS OF ATYPICAL LOCATION

2018 ◽  
Vol 5 (3) ◽  
pp. 157-163
Author(s):  
D. D Shlyk ◽  
Yury E. Kitsenko ◽  
D. R Markaryan ◽  
V. I Lanchinskiy ◽  
I. A Tulina ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Abdominal Cavity ◽  
Malignant Neoplasm ◽  
Early Postoperative Period ◽  
Diagnostic Methods ◽  
Reproductive Age ◽  
Treatment Technique ◽  
Intravenous Contrast ◽  
Preoperative Stage ◽  
Extragenital Endometriosis

Surgical treatment and subsequent management of women of reproductive age with endometriosis of extragenital localization involving intestine, whose frequency is up to 37%, currently do not have a detailed and clearly described protocol, which may be caused by the complexity of diagnosis at the preoperative stage. In most cases, extragenital localization is an intraoperative finding. The purpose of the article is to evaluate the complexity of diagnosing the atypical location of extragenital endometriosis, systematize the diagnostic protocol and present the chosen treatment tactics. Material and methods. In the clinic of coloproctology and minimally invasive surgery, 4 observations of extragenital endometriosis with intestinal lesions were noted. According to the results of diagnostic studies (multispiral computed tomography - MSCT of the abdominal cavity with intravenous contrast, irrigoscopy with double contrasting, colonoscopy with biopsy), endometriosis was confirmed in 2 patients at the preoperative stage. All patients underwent surgical interventions in the volume of resection of the affected segment of the intestine within the unchanged tissues. Results. According to the intraoperative revision, in all patients there was noted the presence of additional extragenital foci of different localization, which were destroyed by diathermocoagulation. Patients with unverified endometriosis also underwent lymphadenectomy in D2 volume due to the inability to exclude malignant neoplasm. In the early postoperative period, no complications were noted. Only 1 patient decided to take hormonal therapy for 6 months after the operation. At present, none of the relapses have been observed, the mean follow-up time is 17.3 ± 13.6 months (4-33 months). In all patients there was recovered the menstrual cycle, menstruation moderately painful, previous abdominal pains before menstruation and spotting discharges from the rectum stopped. Conclusion. Surgical treatment of extragenital endometriosis of intestinal localization in the volume of resection of the affected intestine within the unchanged tissues is the optimal treatment technique and is not accompanied by significant complications. However, in cases of unverified histologically endometriosis, principles of oncological radicalism should be kept. To select the optimal volume of surgical intervention and access, a multidisciplinary consultation with the coloproctologist, gynecologist and with the obligatory consideration of the patient’s opinion is required.

scholarly journals Laparoscopic dissection in children with celiac artery compression syndrome

2021 ◽  
Vol 11 (2) ◽  
pp. 131-140
Author(s):  
Razhab A. Zainulabidov ◽  
Alexander Y. Razumovsky ◽  
Zorikto B. Mitupov ◽  
Galina Y. Chumakova
Keyword(s):  
Abdominal Pain ◽  
Surgical Treatment ◽  
Clinical Symptoms ◽  
Abdominal Cavity ◽  
Treatment Success ◽  
Celiac Trunk ◽  
Early Postoperative Period ◽  
Median Arcuate Ligament ◽  
Flow Measurements ◽  
Arcuate Ligament

BACKGROUND: A cause of abdominal pain in children may be compression stenosis of the celiac trunk (Dunbars syndrome). This disease occurs when the median arcuate ligament of the diaphragm compresses the celiac trunk, thereby creating compression stenosis, causing the arterial hemodynamics in the artery to suffer and provide adequate blood circulation to the abdominal cavity organs. Medical statistics indicate that 10% to 15% of children and adolescents suffering from chronic abdominal pain have compression stenosis of the celiac trunk. AIM: This study aims to improve the diagnostic results and identify the indications for the surgical treatment of children with compression stenosis of the celiac trunk. MATERIALS AND METHODS: From 2015 to 2020 at the N.F. Filatov Childrens Hospital, 64 patients, aged 4 to 17 years underwent surgical treatment for compression stenosis of the celiac trunk. There are 42 boys (66%) and 22 girls (34%). The leading clinical manifestation in all patients was abdominal pain. Associated surgical pathology was observed in 34 of them. The diagnosis was based on anamnesis, examination, ultrasound examination with Doppler and celiac trunk blood flow measurements, multispiral computed tomography, and angiography. RESULTS: After completing the examination, 61 patients underwent laparoscopic decompression of the celiac trunk, and three children were operated on using the laparotomic approach. In all cases, the leading cause of compression stenosis of the celiac trunk was the median arcuate ligament of the diaphragm combined with the neurofibrous tissue of the celiac plexus. The average duration of the operation was 50 minutes. Intraoperative blood loss did not exceed 530 ml. One conversion completed. There were no postoperative complications in the early postoperative period. The patients were discharged in satisfactory condition. The control examination was conducted in the period from six months to three years. In 97% of patients, clinical symptoms of abdominal ischemia were not detected. CONCLUSION: Our experience indicates the possibility of diagnosing compression stenosis of the celiac trunk in children at early disease stages and laparoscopic treatment success of patients with this disease.

scholarly journals MODERN VIEWS ON THE TREATMENT OF PERFORATED PYLORODUODENAL ULCERS

2021 ◽  
pp. 33-36
Author(s):  
D. O. Smetskov ◽  
N. M. Нoncharova ◽  
S. M. Teslenko ◽  
P. V. Svirepo ◽  
A. V. Sivozhelizov ◽  
...  
Keyword(s):  
Peptic Ulcer ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Traditional Method ◽  
Early Postoperative Period ◽  
Perforated Ulcer ◽  
Laparoscopic Suturing ◽  
Ulcer Disease ◽  
Surgical Department ◽  
Results Of Treatment

Summary. Purpose: to improve the results of surgical treatment of patients with perforated pyloroduodenal ulcer. Materials and methods. The results of treatment of 101 patients operated on for perforated pyloroduodenal ulcer, which were treated in the surgical department for the period from 2015 to 2020, were analyzed. Results and discussion. Laparoscopic interventions were performed in 56 (55.4 %) patients with perforated ulcer. Excision of perforated ulcer by traditional laparotomy without vagotomy was used in 26 (25.7 %) patients. Suturing of perforated ulcer by traditional method without vagotomy was performed in 19 (18.8 %) patients. Complications of the early postoperative period in 8 (7.9 %) patients were surgical in nature. In 27 (26.7 %) patients postoperative complications were specific associated with the performance of dilated pyloroduodenoplasty. The largest number of postoperative complications was observed in patients who underwent suturing of the ulcer using traditional laparotomy access – 17 (16.8 %), of which general surgery – 6 (5.9 %), specific – 11 (10.9 %). Conclusions. Laparoscopic suturing of perforated ulcers is accompanied by less pronounced pain, a decrease in the number of postoperative complications, which requires greater use of endovideo-surgical technologies in this complication of peptic ulcer disease.

scholarly journals EN BLOCK RESECTION OF THE GIANT INVASIVE SCHWANNOMA IN THE THORACOLUMBAR SPINE

2019 ◽  
Vol 16 (1) ◽  
pp. 81-87
Author(s):  
D. V. Kuklin ◽  
D. G. Naumov ◽  
M. V. Belyakov ◽  
I. A. Sovpenchuk ◽  
M. S. Serdobintsev
Keyword(s):  
Surgical Treatment ◽  
Clinical Case ◽  
Thoracolumbar Spine ◽  
Pain Syndrome ◽  
Single Stage ◽  
Lower Limbs ◽  
Vas Scores

The paper presents a rare clinical case of surgical treatment of a patient with a giant invasive schwannoma of the thoracolumbar spine. A single-stage en block resection of the tumor through a combined posteroanterior approach was performed followed by replacement of post-resection interbody diastasis with a carbon implant and by posterior instrumental fixation of the spine. The pain syndrome regressed from VAS scores 7 and 8 (back, lower limbs) to scores 4 and 1, respectively. The follow-up examination was conducted at 6 and 12 months after surgery: there were no signs of relapse. Publications on giant invasive spinal schwannomas were analyzed.

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