scholarly journals The Role of Hydrocolonic Sonography in Diagnostics of the Intussusceptions due to Neoplastic Process in Children

2019 ◽  
Vol 9 (1) ◽  
pp. 5-12
Author(s):  
M Yu. Yanitskaya ◽  
I. A. Turabov

Introduction. A nonsurgical reduction is the treatment of choice for intestinal intussusception. A neoplasm-associated intussusception always requires surgery. In case of a tumour it is very important to have the diagnosis determined prior to surgical treatment. The hydrocolonic sonography technique makes it possible to assess the tissue structure and to visualize the lumen of the intestine.Materials and methods. The study presents a retrospective comparative analysis of clinical manifestations and diagnosis methods in all the patients with intussusception (n = 380) treated at the Arkhangelsk Children’sClinicalHospital in 1981–2018. This included all the neoplasm-associated intussusception cases (tumours and polyps). The data was compared to clinical manifestations of intussusception associated with other causes (idiopathic, mesenteric node hyperplasia, diverticulum).Results. Neoplasm-associated intussusception is a rare occurrence (2.3%). If the cause of the intussusception is a tumour the typical recorded manifestations include the combination of the signs of gastrointestinal diseases and loss of weight (8–12%), and a chronic course of development (over one to three months). Polyp-associated small intestinal and ileocolic intussusception, a casuistically rare situation, first manifested as an acute intestinal obstruction with protracted abdominal pain syndrome in anamnesis, or recurrent intussusceptions. Traditional and hydrocolonic sonography made it possible to make the diagnosis of intussusception and to identify a tumour. Non-tumour-associated intussusception presented with an acute course of the disease in every case. It manifested with the typical triad of symptoms (abdominal colic pain, rectal haemorrhage, palpable intussusceptum mass) in every third case. The manifestation of the disease as the dyad of symptoms (vomiting and abdominal colic pain) was significantly more frequent (p = 0.001).Conclusions. Clinical presentation of neoplasm-associated intussusception has certain unique qualities. The ultrasound of abdominal cavity and hydrocolonic sonography make it possible to find the intussusception and to identify the tumour or polyp in the structure of the intussusceptum in 100 % of cases at primary examination. The data obtained is used for the optimisation of the surgical treatment strategy.

2007 ◽  
Vol 6 (3) ◽  
pp. 43-50
Author(s):  
V. A. Koubyshkin ◽  
I. A. Kozlov ◽  
N. I. Yashina ◽  
T. V. Shevchenko

The experience of surgical treatment of 154 patients having chronic pancreatitis with preferential injury of the pancreas head which underwent different operative interventions: isolated resection of pancreatic head ( based upon Berger surgery - 24, Frey surgery - 39), pancreatoduodenal resection ( with gastric resection - 22, with preserved pylorus - 43) and drainage surgeries - 26 is presented in the article. The surgery of isolated resection of pancreatic head has less number of nearest unfavorable results compared with pancretoduodenal resection with preserved pylorus. Proximal resection of the pancreas the variants of which are different isolated resection of pancreatic head is superior upon surgeries with full or partly resection of the duodenum due to fast normalization of the motor-evacuation function, less rate of the intestinal reflux and portion character of duodenal evacuation. In the follow-up period after pancreatoduodenal resection, atrophic processes occur in distal areas of the pancreas which are followed by clinical manifestations of exo- and endocrinous insufficiency. The surgery of longitudinal pancreatic jejunostomy does not avoid pathologic changes in the organ head and pain syndrome.


2017 ◽  
Vol 25 (2) ◽  
pp. 247-262
Author(s):  
D. A. Rahmonov ◽  
F. Sh. Rashidov ◽  
E. L. Kalmykov ◽  
M. M. Marizoeva ◽  
O. B. Bobdjonova ◽  
...  

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.


2019 ◽  
Vol 21 (2) ◽  
pp. 63-69
Author(s):  
M N Kravtsov ◽  
D V Pomet'ko ◽  
V I Leonov ◽  
B V Gaydar ◽  
D V Svistov

The results of the conservative and surgical treatment of 12 patients at the Neurosurgery Clinic of the Military medical academy. CM. Kirov, in the period 2016-2018, about the paraarticular and disc cysts of the lumbar spine. Performed open microsurgical and full-endoscopic operational aids. Evaluation of the effectiveness of surgical treatment was carried out using the subjective assessment scale and magnetic resonance imaging over time. The follow-up period ranged from 6 to 24 months. Most often, extradural cysts were located at the level of the LIV-LV segment. Clinical manifestations were characterized by radiculopathy and local back pain. The average duration of pain syndrome was 3±0,7 months. Conservative treatment led to a regression of pain and resorption of a disk cyst in one patient. In other cases, surgical treatment was required. The average duration of a microsurgical operation was 131,6±73,4 minutes, video endoscopic - 80±10,8 minutes. The hospitalization period in the group of microsurgical treatment was 10,4 days, in the group of video endoscopy - 4,7 days. Control magnetic resonance imaging revealed the recurrence of paraarticular cysts in the area of the previous operation in 3 patients. Relapse in patients with disc cysts is not marked. Necessity in repeated operations did not arise in one supervision. It has been established that the main clinical manifestations of extradural cysts of the lumbar spine are local moderate pain, radiculopathy, and intermittent claudication. Microsurgical and percutaneous video endoscopic treatment of lumboischialgia due to extradural cysts is significantly more effective compared with conservative therapy. Full-endoscopic interventions in comparison with microsurgical ones are less invasive and long-lasting and can reduce the time of inpatient treatment.


2021 ◽  
Vol 13 (1) ◽  
pp. 31-37
Author(s):  
U. A. Bagirova ◽  
E. G. Chernukha ◽  
E. G. Filatova

Migraine is often concurrent with endometriosis; however, the mechanisms of comorbidity of these conditions are inadequately studied. Pain is considered as the most significant clinical symptom and maladaptive manifestation of both migraine and endometriosis. Studying the relationship between the clinical manifestations of pain syndrome in patients with endometriosis and migraine is important, since it will contribute to the understanding of the mechanisms of comorbidity of these diseases.Objective: to analyze the features of pain syndrome in patients with migraine and genital endometriosis to clarify the neurogenic mechanisms of their comorbid relationship.Patients and methods. A total of 125 patients who had gone to a gynecologist for endometriosis were examined for the presence of migraine. In accordance with the inclusion criteria, 79 patients (mean age, 34.68±7.11 years) with genital endometriosis confirmed by diagnostic laparoscopy participated in the further study. Two age-matched groups were formed: a study group consisted of 38 patients with endometriosis and concomitant migraine; a comparison group included 41 patients with endometriosis without migraine. All the patients underwent clinical neurological examination, questionnaire survey, pelvic ultrasound, assessment of the severity of pelvic pain according to the pelvic pain index, and determination of the level of central sensitization (CS) using the CS Inventory.Results and discussion. 42% out of the 125 patients who had visited their gynecologist for endometriosis suffered from concomitant migraine, which confirms the comorbidity of these diseases. Chronic pelvic pain (CPP), dysmenorrhea, dyspareunia, and dyschesia were more common in patients with endometriosis and migraine; there were more patients with asymptomatic endometriosis in the comparison group. The patients of the two groups did not differ in the presentation of different forms of endometriosis, which favors the leading role of central mechanisms in the pathogenesis of pain syndrome in comorbidity of these diseases.In addition, there was a statistically significant increase in the presentation of CPP and dysmenorrhea in patients with chronic migraine compared to those with episodic migraine and to those without migraine. Significantly higher levels of CS according to CSI and pelvic pain index were found in patients with chronic migraine and endometriosis, which suggests that CS plays a key role in the comorbidity of these diseases.Conclusion. The phenomenon of CS is one of the mechanisms of comorbidity of migraine and endometriosis, contributes to both the worsening of various painful manifestations of endometriosis and the increase in migraine attacks, thereby causing obvious maladaptation in patients. The role of CS in the comorbidity of migraine and endometriosis opens up possibilities for the elaboration of a comprehensive interdisciplinary approach to treating these diseases.


2011 ◽  
Vol 10 (2) ◽  
pp. 73-76
Author(s):  
Ye. B. Kolotov ◽  
R. R. Aminov ◽  
S. V. Yelagin ◽  
V. V. Kelmakov ◽  
Ye. V. Kolotova

To improve the results of surgical treatment the patients with discogenic compressive syndromes. Using the denervation of interbody discs and facet joints in series allow us, first off all, to induce, and then to discontinue the reflex-pain syndrome in 41 patients in preoperational period, and in 39 patients in long-term postoperative period. Good results come to 82,8 и 89,8% (р < 0,05) accordingly.


2021 ◽  
Vol 50 (4) ◽  
pp. 21-24
Author(s):  
V. I. Konovalov ◽  
A. V. Vorontsova

Comparative analysis of the endometriosis main clinical manifestations (pain syndrome in the small pelvic area, menstrual and generative functions disorders, adjacent organs dysfunction) has been carried out in 111 women in long-term period after efficient operative interventions and 371 women with endometriosis who didnt get any treatment. None of the above-mentioned methods of the efficient surgical treatment turned to be optimal (long-term and effective) for cutting short the main clinical manifestations of endometriosis.


2019 ◽  
Vol 23 (3) ◽  
pp. 119-123
Author(s):  
Pyae Swe Aung ◽  
Viktoria V. Kholostova

Introduction. Hemorrhoids in childhood is a rare disease. That is why one can find only few works on this problem. Material and methods. 56 children with diagnosed hemorrhoids aged 4-18 were taken into the study. They had various clinical manifestations of the disease: perianal protrusion (76.4%), bleeding (82.3%), pain syndrome (71.5%). 51 patient (91.1%) had external hemorrhoids; 3 children (5.3%) - internal; 2 children (3.6%) - combined. Patients, by their clinical course, were distributed as follows: acute hemorrhoids - 33 children (58.9%), chronic one - 23 (41.1%). Ultrasound examination and sigmoidoscopy were used for diagnostics. Different curative techniques followed the developed curative algorithm: conservative therapy and surgery (open surgery and with the LigaSure apparatus) as well as sclerotherapy. Results. The most effective technique, having better cosmetic and clinical outcomes, was hemorrhoidectomy. Conservative treatment (more than 80%) can be a method of choice at early stages of the disease and at younger age groups. Outcomes after sclerotherapy are comparable with outcomes of conservative and surgical treatment. Sclerotherapy is recommended at the internal stages of hemorrhoids and in case of any contraindications to surgical treatment.


2021 ◽  
Vol 9 (1) ◽  
pp. 101-106
Author(s):  
S.V. Leonchenko ◽  
◽  
V.N. Petyushkin ◽  
A.P. Motin ◽  
A.A. Dyomin ◽  
...  

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.


2013 ◽  
Vol 94 (2) ◽  
pp. 221-227
Author(s):  
A T Zabbarova ◽  
E I Bogdanov ◽  
D K Khusainova ◽  
L S Fatkheeva

Aim. To analyze the prevalence and role of comorbidities in variety of clinical manifestations in patients with congenital occipital hypoplasia - «overcroded posterior cranial fossa» syndrome. Methods. Clinical history and physical examination of 200 patients (aged 16-74 years, males 108, females 92) with «overcrowded posterior cranial fossa» syndrome, including 134 with cerebellar ectopia, 92 with syringomyelia, 24 with hydrocephalus, were analyzed. Results. The diseases identified in patients with «overcrowded posterior cranial fossa» syndrome were combined into six groups: cardiovascular diseases (n=120; 60.0%), infectious and inflammatory diseases (n=39; 19.5%), gastrointestinal diseases (n=37; 18.5%), metabolic and endocrine diseases (n=31; 15.5%), diseases of the musculoskeletal system and connective tissue (including cervical vertebral stenosis (n=53; 26.5%), scoliosis (n=50; 25.0%), arthropathies (n=21; 10.5%), other diseases and pathological conditions (including mild traumatic brain injury (n=74; 37.0%), seizures (n=13; 6.5%). In patients with «overcrowded posterior cranial fossa» syndrome the prevalence of cardiovascular, gastrointestinal diseases, traumatic brain injury, obesity, primary or secondary cervical vertebral stenosis was significantly higher (p 0.05) compared to general population. In patients with syringomyelia a higher rate (p0.05) of scoliosis and traumatic brain injury was revealed. Conclusion. The prevalence of comorbidities in patients with «overcrowded posterior cranial fossa» syndrome was higher compared to general population. The differences of the type and rate of the concomitant diseases in patients with various forms of the syndrome may contribute to the variety of clinical manifestations of «overcrowded posterior cranial fossa» syndrome.


Author(s):  
Yu.A. Orlova ◽  
V.B. Martynenko

The article outlines the issue of endometrioid disease, known as a complex gynecological polyetiological pathology. The total coverage of this pathology among women is 10%, with its spread up to 70% among women of reproductive age. The diversity and severity of clinical symptoms worsen not only the physical condition of the woman, but emotional status as well. To date, complicacy in the diagnosis and treatment of the disease gives raise a number of challenges requiring solution. Thus, endometriosis is still remaining a promising area of study, The aim of this study was to characterize the features of the anamnesis and symptoms of women with endometriosis, to determine the diagnostic value of the examination methods, to evaluate the effectiveness of the treatment tactics of women with this pathology. We carried out a retrospective analysis of case histories of 61 women with endometriosis. The diagnosis was 100% histologically confirmed. The average age of the women studied was 30,44 ± 5,6 years. Body mass index was 23,04 ±3,87 kg / m2. 16 women (26.22%) were diagnosed as overweight; 1st degree obesity was found in 2 women (3,27%). The onset of menstruation averaged 13,04 ± 1.07 years. Late onset of menarche was found out in 2 women (3,21%). The duration of menstruation ranged from 4,67 ±1.44 to 5,37 ±1,29 days with 1 reported case of menstrual bleeding for more than 8 days. 55,7% of women reported excessive menstrual blood loss. The interval of the menstrual cycle ranged from 21 to 32 days, was regular and amounted to 27,6±2.31 days. 47,54% of women experienced pain during menstruation. The increasing intensity of the pain syndrome from the moment of diagnosis was noted by 14 women, that made up to 48,27% of cases among 29 women with endometriosis and painful menstruation. There were 22 cases of pregnancy; miscarriages were recorded in 2 women (9,09%). 20 women (32,7%) had infertility, and in all the cases infertility was primary. When assessing the position of the uterus in the pelvis, it was revealed that 7 women (11,47%) had a retrograde uterine location, namely in the retroflexio position. When assessing the somatic history of the women studied, we noted that insult of various organs and systems was revealed in 53 women (86,88%). Top list is occupied by the gastrointestinal diseases, 64,1% of 53 studied cases. In addition to the underlying disease, 24 women (39,34%) had a history of gynaecological pathology. Carbohydrate antigen 125 was determined in 73,77% of cases, but only in 25 of these women this level was higher than 35.0 U / ml. Its value was established only in 55,5% of women. The detection of human epididymal protein 4 was carried out in 17 women (27,86%). Among these women, only in 1 case the level of human epididymal protein 4 exceeded the age normal values and was at the level of 69,59 pmol / L. By ultrasound diagnostic method, endometriosis was established only in 58,3% of cases. One woman was diagnosis to have endometriosis during magnetic resonance imaging. Therapy of endometriosis is divided into conservative and surgical. Before surgical treatment, 31 women (50,81%) were chosen for conservative management tactics, resulted in no effect. During surgical treatment with laparoscopic access, visible endometrioid heterotopies were observed in 50 women (81,96%), and in 18,04% endometriosis was not endoscopically diagnosed, while histologically was confirmed in 100% of cases. It is noteworthy that 46 women (75,4%) had adhesions of the pelvic organs, but only 22 women (47,82%) had had any surgical abdominal interventions before. Thus, endometriosis is a disease, which can not be described from a single unified point of view regarding its etiological factors. Severe clinical symptoms, the inability to use only non-invasive diagnostic methods for diagnosis, and the lack of comprehensive treatment that would provide the absence of relapse after the course of treatment, persistently force researchers and clinicians to deepen their knowledge and continue searching for methods to solve the problems of early diagnosis, treatment and prevention of the disease.


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