scholarly journals THE USE OF X-RAY ENDOVASCULAR METHODS OF DIAGNOSIS AND TREATMENT IN A PATIENT WITH POSTTRAUMATIC HEMOBILIA DUE TO PENETRATING WOUND OF THE ABDOMINAL CAVITY. OUR OWN EXPERIENCE

2021 ◽  
Vol 5 (1) ◽  
pp. 85-88
Author(s):  
K. S. Belyuk ◽  
◽  
E. V. Mogilevets ◽  
A. V. Zabolotnaya ◽  
D. Y. Yakovchik ◽  
...  
Keyword(s):  
Liver Injury ◽  
Clinical Case ◽  
Abdominal Cavity ◽  
Diagnostic Methods ◽  
Diagnosis And Treatment ◽  
Midline Laparotomy ◽  
X Ray ◽  
Penetrating Wound ◽  
Abdominal Bleeding ◽  
Endovascular Methods

Background. Hemobilia is the excretion of blood alongside with bile through intra- and extrahepatic bile ducts. Despite the use of new methods of diagnosis and treatment, the mortality rate from hemobilia remains high (20-40%). Objective. To demonstrate a clinical case and some methods of diagnosis and treatment of a patient with hemobilia. Material and methods. The article presents our own clinical observation of a patient with a penetrating knife wound of the abdominal cavity with liver injury complicated by hemobilia. Two-stage treatment was performed including upper midline laparotomy, cholecystectomy, and biliary tract sanitation with external drainage of the common bile duct according to Pikovsky in combination with angioembolization of the damaged artery of the 4th liver segment. Results. The analysis of the clinical case shows X-ray endovascular methods to be one of the promising ways of increasing surgical management efficiency of traumatic hemobilia. Conclusions. This observation shows the possibility of developing hemobilia without signs of intra-abdominal bleeding in penetrating abdominal wounds with liver injury. The use of X-ray endovascular diagnostic methods can improve treatment outcomes of patients with hemobilia of traumatic origin.

scholarly journals Endometriosis as a Reason of Intraabdominal Bleeding in Pregnancy. Clinical Case

2019 ◽  
Vol 23 (3) ◽  
pp. 283-289
Author(s):  
Y. A. Revzoeva ◽  
E. Y. Shakurova
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Laboratory Tests ◽  
Clinical Case ◽  
Abdominal Cavity ◽  
Diagnostic Procedures ◽  
Reproductive Period ◽  
Diagnostic Methods ◽  
Dark Blood ◽  
Abdominal Bleeding

The article defines the significance and relevance of the problem of endometriosis during pregnancy. 10% of women in the reproductive period have different localization of endometriosis. 25% of pregnancies with endometriosis are complicated by preterm labor. The article presents a clinical case of intra-abdominal bleeding in a 28-year-old pregnant woman with retrocervical endometriosis at gestation age of 32 weeks and 6 days. The article covers the results of examination and special diagnostic procedures of intra-abdominal bleeding in pregnant women with retrocervical endometriosis. The main diagnostic methods were the study of past medical history, ultrasound examination, and laboratory tests. Due to their infrequency during pregnancy internal bleedings present difficulties in their diagnosis. Ultrasound reliably revealed a large amount of fluid in the abdominal cavity and small pelvis and excluded the presence of intrauterine bleeding. Clinical and laboratory tests indicated the severity of the patient's condition. Symptoms of moderate fetal distress were also identified. Therefore, a decision was made about an emergency delivery by the cesarean section followed by an abdominal revision. During the cesarean section, 500 ml of blood in the form of dark blood clots was found in the abdominal cavity. The condition of the premature newborn was in conformity with his gestational age. The source of bleeding were the of endometriosis on the back wall of the uterus. These focuses most likely caused hemoperitoneum. The revision of the abdominal cavity did not find any other foci of bleeding. The postoperative period was uneventful. The article provides general guidelines for the management of pregnant women with severe forms of endometriosis.

scholarly journals Paraganglioma of the urinary bladder. Experience in surgical treatment

2021 ◽  
Vol 14 (1) ◽  
pp. 156-160
Author(s):  
A.Yu. Pavlov ◽  
◽  
A.G. Dzidzaria ◽  
A.D. Tsybulsky ◽  
S.V. Fastovets ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Clinical Case ◽  
Clinical Course ◽  
Intraoperative Complications ◽  
Diagnostic Methods ◽  
Diagnosis And Treatment ◽  
Federal State ◽  
Optimal Method ◽  
Correct Treatment

Introduction. Pheochromocytoma is a tumor that develops from the chromaffin tissues of the sympathetic nervous system. The most frequent localization is the adrenal medulla. However, in about 10% of cases, pheochromocytomas can occur in ectopic or extrarenal localities (the brain and up to the pelvic organs). An ectopic pheochromocytoma is called a paraganglioma. It may be difficult for doctors to determine an accurate diagnosis due to the fact that the disease emits bladder cancer in its clinical manifestation. The rare localization and poorly understood structure of the tumor also makes it difficult for specialists to determine the correct treatment strategy. This article describes a rare clinical case that clearly demonstrates all stages of the clinical course, diagnosis, and treatment of bladder parganglioma. Materials and methods. We are looking at a clinical case that occurred in the clinic of the Federal state budgetary institution RSCR. This article describes in detail all stages of the clinical course, methods of diagnosis and treatment of paraganglioma of the bladder. Clinical practice and results. Paragangliomas are rare tumors of the bladder. They may have clinical, radiological, and pathological features similar to bladder cancer. Typical symptoms are catecholamine secretion, especially associated with periods of urination. Conclusions. The optimal method of treatment is laparoscopic or open resection of the bladder. Other methods of treatment, such as transurethral resection, can be considered as effective diagnostic methods, but as an independent treatment option, they are associated with non-radicality and a high risk of intraoperative complications. In the future, it is critical to standardize the principles of examination, treatment and follow-up of patients with paraganglioma of the bladder.

scholarly journals A Clinical Case of Stomach Perforation Concealed by a Foreign Body

2020 ◽  
Vol 10 (3) ◽  
pp. 228-232
Author(s):  
M. R. Garaev ◽  
M. Yu. Vorotnikov ◽  
Z. R. Garayeva ◽  
M. A. Nartaylakov
Keyword(s):  
Foreign Body ◽  
Clinical Picture ◽  
Clinical Case ◽  
Foreign Bodies ◽  
Abdominal Cavity ◽  
Clinical Manifestations ◽  
Diagnostic Methods ◽  
Satisfactory Condition ◽  
Therapy Choice ◽  
Ct Data

Introduction. Stomach perforations caused by ingested foreign bodies are extremely rare injuries in adults, accounting for less than 1% of all gastrointestinal perforations. The clinical picture is diverse and often presents a diagnostic problem. There are few publications reporting such cases in literature.Materials and methods. Using the example of a clinical case, this paper describes the clinical picture, diagnostic role of X-ray instruments and surgical tactics of diagnosing and treating a stomach perforation concealed by a foreign object, which occurred one week prior to admission. The patient V., 52 yo, was admitted to hospital on an emergency basis in the condition of moderate severity, complaining of abdominal pain for two days. The onset of the disease had no apparent reason. Similar pains had bothered the patient a week earlier the incident but were relieved without treatment.Results and discussion. On the basis of clinical and laboratory-instrumental data, acute pancreatitis was pre-diagnosed. Conservative drug therapy with positive dynamics was started. Two days later, computed tomography of the abdominal organs with intravenous bolus contrast was performed. According to the CT data, a foreign body in the abdominal cavity was identified, which rested on the liver at the level of the gallbladder, perforating the wall of the pyloric department of the stomach. Localized inflammatory effusion in the abdominal fat was observed. The patient was operated and discharged in satisfactory condition.Conclusion. Stomach perforations caused by small-sized foreign bodies are characterized by non-specific clinical manifestations. The use of radiation diagnostic methods facilitates the timely diagnosis and therapy choice in patients with stomach perforations caused by small-sized foreign bodies. 

scholarly journals A clinical case of pulmonary and hepatic echinococcosis

2017 ◽  
Vol 98 (2) ◽  
pp. 261-266
Author(s):  
M L Gorbunova ◽  
S N Volkova ◽  
G V Shestakova ◽  
E L Spiridonova
Keyword(s):  
Differential Diagnosis ◽  
Clinical Case ◽  
Clinical Presentation ◽  
Final Diagnosis ◽  
Primary Diagnosis ◽  
Diagnostic Methods ◽  
X Ray ◽  
Chest X Ray ◽  
Pulmonary Echinococcosis ◽  
Hepatic Echinococcosis

The article presents а description of our personal case of pulmonary and hepatic echinococcosis in a 38-years-old patient. Literature data on clinical presentation, laboratory and instrumental diagnostic methods of the disease are presented. Different variants of clinical presentation of pulmonary echinococcosis and its possible complications are described. The problems of differential diagnosis, surgical and conventional methods of treatment are analyzed. The presented clinical case confirms the wide spread opinion that the diagnosis of pulmonary echinococcosis based on only the results of chest X-ray is extremely challenging. Frequent diagnostic mistakes are associated with the primary diagnosis of pneumonia based on chest X-ray. Use of high-pitch spiral computed tomography implemented recently into clinical practice provides early differential diagnosis of pulmonary lesions with parasitic diseases, in particular, with echinococcosis. The final diagnosis is confirmed by serologic methods of echinococcosis diagnosis with the use of enzyme immunoassays.

scholarly journals Diagnosis and treatment characteristics of mucinous ovarian tumors

2021 ◽  
Vol 70 (2) ◽  
Author(s):  
Tudor Rotaru ◽  
◽  
Rotaru Ludmila ◽  
Daniela Mocan ◽  
Nicu Balan ◽  
...  
Keyword(s):  
Tumor Marker ◽  
Abdominal Cavity ◽  
Clinical Signs ◽  
Laboratory Diagnosis ◽  
Ovarian Tumors ◽  
Diagnostic Methods ◽  
Diagnosis And Treatment ◽  
Ca 125 ◽  
Benign Ovarian Tumor ◽  
Mucinous Ovarian Tumors

Ovarian tumors occupy a special place in gynecological pathology due to their great diversity, diagnostic difficulties, specifying their evolutionary nature, establishing the prognosis and treatment. Ovarian mucinous tumors are a group of rare formations, with a cell of as yet undefined origin, but with an apparent progression from benign to borderline and carcinoma. The treatment of a benign ovarian tumor is surgical. Material and methods. The research in question was performed on a group of 50 patients, who were treated in the gynecology department of the IMSP Oncological Institute of the Republic of Moldova, with the diagnosis of mucinous ovarian tumors. Results. The study analyzed data on the diagnosis and treatment of mucinous ovarian tumors. The clinical diagnosis showed a unilateral ovarian involvement in 41 cases (82%) compared to the bilateral one registered in 9 patients (18%). All tumors were large and irregularly shaped. In the case of laboratory diagnosis in assessing the benign or malignant tumor potential, the tumor marker CA-125 was performed, in 41 patients the index was within the norm range from 0-35U / ml and only in 9 cases were there insignificant increases of 50-100U / ml. Ultrasonographic diagnosis is an important method in detecting mucinous ovarian tumors. The treatment of patients is surgical and, depending on the appearance of the tumor intraoperatively and age, they had a radical or less radical character. Conclusions. The most common clinical signs were fullness in the pelvis, dysuria, pain in the lumbar or sacral region. As usual, the mucous ovarian tumors are large. The CA-125 tumor marker was in most cases within the normal range. Imaging investigations are informative and some of them applied to all patients in the study. Endoscopic diagnostic methods are less informative in mucinous ovarian tumors due to bulky formations and the risk of effusion of the mucin into the abdominal cavity.

The Role of Laparoscopic Technology in the Diagnosis and Treatment of Acute Surgical Pathologies of the Abdominal Cavity Organs

2018 ◽  
Vol 3 (2) ◽  
pp. 175-180
Author(s):  
F. G. Jamalov ◽  
◽  
M. M. Abdullaev ◽  
E. V. Nabieva ◽  
Т. P. Jamalova ◽  
...  
Keyword(s):  
Abdominal Cavity ◽  
Diagnosis And Treatment

Clinical case of a comorbid patient with arterial hypertension

2020 ◽  
pp. 31-39
Author(s):  
Ella Polozova ◽  
Vsevolod Skvortsov ◽  
Olga Radaykina ◽  
Mariya Narvatkina ◽  
Anastasiya Seskina ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Risk Factors ◽  
Arterial Hypertension ◽  
Clinical Picture ◽  
Clinical Case ◽  
Diagnosis And Treatment ◽  
The Moment

The widespread prevalence of comorbid pathology determines the relevance of this problem. Comorbid pathology due to the interaction of diseases, drug pathomorphism, age characteristics of the patient, significantly changes clinical picture and course of the main nosology, affects severity of complications and their nature, significantly affects quality of life and prognosis of patients. Diagnosis and treatment of many diseases is complicated in the conditions of comorbidity. The article presents a clinical case of a comorbid patient with arterial hypertension from the moment of exposure to risk factors and ending with the formation of many concomitant diseases, as an example of trans-nosological comorbidity.

scholarly journals A case of pleuroperitoneal communication in which establishing a laparoscopic pneumoperitoneum was useful for the detection of a fistula

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Takehiko Manabe ◽  
Kenji Ono ◽  
Soichi Oka ◽  
Yuichiro Kawamura ◽  
Toshihiro Osaki
Keyword(s):  
Thoracic Surgery ◽  
Surgical Repair ◽  
Abdominal Cavity ◽  
Case Presentation ◽  
X Ray ◽  
Video Assisted Thoracic Surgery ◽  
Video Assisted ◽  
Pleuroperitoneal Communication ◽  
Small Pore ◽  
Chest X Ray

Abstract Background Pleuroperitoneal communication (PPC) is rarely observed, accounting for 1.6% of all patients who undergo continuous ambulatory peritoneal dialysis (CAPD). Although there have been several reports concerning the management of this condition, we have encountered several cases in which control failed. We herein report a valuable case of PPC in which laparoscopic pneumoperitoneum with video-assisted thoracic surgery (VATS) was useful for supporting the diagnosis and treatment. Case presentation The patient was a 58-year-old woman with chronic renal failure due to chronic renal inflammation who was referred to a nephrologist in our hospital to undergo an operation for the induction of CAPD. Post-operatively, she had respiratory failure, and chest X-ray and computed tomography (CT) showed right-sided hydrothorax that decreased when the injection of peritoneal dialysate was interrupted. Therefore, PPC was suspected, and she was referred to our department for surgical repair. We planned surgical treatment via video-assisted thoracic surgery. During the surgery, we failed to detect any lesions with thoracoscopy alone; we therefore added a laparoscopic port at her right-sided abdomen near the navel and infused CO2 gas into the abdominal cavity. On thoracoscopy, bubbles were observed emanating from a small pore at the central tendon of the diaphragm, which was considered to be the lesion responsible for the PPC. We closed it by suturing directly. Conclusions VATS with laparoscopic pneumoperitoneum should be considered as an effective method for inspecting tiny pores of the diaphragm, especially when the lesions responsible for PPC are difficult to detect.

Przewlekły kaszel jako główna manifestacja chłoniaka Hodgkina – opis przypadku

2019 ◽  
Vol 23 (3) ◽  
Author(s):  
Katarzyna Wójcicka ◽  
Andrzej Pogorzelski
Keyword(s):  
Chronic Cough ◽  
Correct Diagnosis ◽  
Diagnostic Methods ◽  
Radiographic Examination ◽  
Older Children ◽  
X Ray ◽  
Volume Curve ◽  
Flow Volume Curve ◽  
Mediastinal Widening ◽  
Chest X Ray

A cough lasting longer than 4-8 weeks, defined as chronic cough, always requires thorough diagnostic evaluation. In addition to detailed history-taking and physical examination, simple and available diagnostic methods, such as chest x-ray and spirometry, should be performed. They may be helpful tool to establish the underlying cause of cough. Many younger children may have difficulties in performing the forced expiratory maneuvers and fulfilling repeatability criteria for spirometry. The disturbances resulting from insufficient cooperation should be considered in interpratation of the obtained results. The shape of the flow-volume curve, which suggests upper or central airways obstruction, can not be ignored and always requires further investigation for diagnosis of respiratory pathology. The chest x-ray is the most frequently performed radiographic examination in children. Accurate interpretation is essential in reaching a correct diagnosis. Mediastinal widening on the chest x-ray in children can occur due to a large variety of causes. The normal thymus can take on a variety of sizes and shapes and still be considered normal in the first few years of life. In older children mediastinal widening should be differentiated from mediastinal masses. Lymph node enlargement represents a frequent cause, usually as a result of infection or malignancy. The article reports a case of a 12-year-old boy with chronic cough, mediastinal widening on the chest X-ray and abnormal spirometry results, who was finally diagnosed with stage III Hodgkin’s lymphoma.

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