scholarly journals Epidemiology of intra-abdominal infiltrates and abscesses in patients with concomitant diseases and diabetes mellitus

2021 ◽  
pp. 27-36
Author(s):  
V. V. Skyba ◽  
V. F. Rybalchenko ◽  
A. V. Ivanko ◽  
Dar Yasin Akhmed
Keyword(s):  
Diabetes Mellitus ◽  
Duodenal Ulcer ◽  
Gastric Ulcer ◽  
Arterial Pressure ◽  
Musculoskeletal System ◽  
Fourth Group ◽  
Abdominal Complications ◽  
Urgent Surgery ◽  
Perforated Gastric Ulcer ◽  
Adhesive Obstruction

The purpose ofthe work — to study the epidemiological factors in the development of primary and secondary intra-abdominal infiltrates, abscesses and fluid formations in patients with concomitant diseases and diabetes. Material and methods. In the clinic of the Department of Surgical Diseases No. 1, on the basis of the Center of Surgery of the Kiev City Clinical Hospital No. 1 from 2006 to 2019,218patients with primary and secondary intra-abdominal infiltrates, abscesses and fluid formations were treated. The patients’ age ranged from 16 to 85 years. There were 107 male patients (49.08 %), 111 female patients (50.92 %). X-ray examination was performed in 112 (51.38 %) patients, computed tomography (CT) in 25 (11.48 %),ultrasound examination of the abdominal organs for 105 (4816 %) patients. Anterior abdominal wall thermometry was performed in 76 (34.86 %) patients. Resultsand discussion. Depending on the cause of the development of intra-abdominal infiltrates, abscesses and fluid formations, the patients were divided into 4 groups. Patients of the first, second and third groups had primary intra-abdominal complications, and in the fourth group patients had secondary postoperative complications. The first group included 74 (33.94 %) patients suffering from a complicated course of destructive appendicitis. The second group included 48 (22.02 %) patients suffering from perforated gastric ulcer and 12 duodenal ulcer. The third group included 69 (31.65 %) patients suffering from cholecystitis and various types of complications. The fourth group included 27 (12.39 %) patients who underwent urgent surgery due to strangulated hernias, adhesive obstruction. The study of the scales showed that: in 87 (39.91 %) the weight was within normal limits, and in 131 (60.09 %) patients were overweight and obese. It was found that 126 (57.80 %) patients wore glasses. Diseases of the cardiovascular system and arterial pressure disorders according to the data of case histories and anamnesis had 123 (56.42 %) patients. Diabetes was diagnosed in 38 (17.43 %) patients. Diseases of the musculoskeletal system were diagnosed in 27 (12.38 %) patients, and 48 (22.02 %) patients suffered from flat feet of various stages. Primary intra-abdominal complications(infiltrates and abscesses) were diagnosed in 191 (3.48 %) patients out of 5483 urgent hospitalizations and operations, of which 74 (1.35 %) with appendicitis, 69 (1.26 %), perforated gastric ulcer and 12 duodenal ulcer in 48 (0.87 %) patients. Secondary postoperative infiltrates, abscesses and fluid formations were found in 27 (18.12 %) of 149 patients who had undergone urgent abdominal surgery (adhesive obstruction, incarcerated and postoperative hernias, etc.), and in 29 (15.18 %) of 191 patients who underwent surgery for primary intra-abdominal complications of the underlying disease and urgent surgery. Diabetes mellitus was diagnosed in 38 (17.4 3%) patients, and therefore all patients who are hospitalized in an urgent and planned manner must undergo a comprehensive clinical and laboratory examination with the determination of blood sugar. The presence of established diabetes mellitus requires the consultation of an endocrinologist, and during the operation it is advisable and necessary to correct glycemic and volemic disorders, which continues until the restoration of vital functions and stabilization of the general condition of the patient. Intra-abdominal complications occurred on the background of concomitant diseases: overweight in 28.44 %, visual impairment in 57.80 %, diseases of the cardiovascular system and arterial pressure disorders in 56.42 %, diseases of the musculoskeletal system in 12.38 %, which indicates the need for an individual approach in the treatment of each patient. 

scholarly journals Evolution of diagnosis and surgical treatment of intra-abdominal infiltrates, abscesses of primary and postoperative origin in patients

2021 ◽  
pp. 15-29
Author(s):  
V.V. Skyba ◽  
◽  
V.F. Rybalchenko ◽  
A.V. Ivanko ◽  
R.М. Borys ◽  
...  
Keyword(s):  
Duodenal Ulcer ◽  
Gastric Ulcer ◽  
Surgical Treatment ◽  
Abdominal Cavity ◽  
Postoperative Mortality ◽  
Multiple Organ ◽  
Long Term Results ◽  
Control Group ◽  
Study Group ◽  
Perforated Gastric Ulcer

Purpose – to improve the results of surgical treatment of patients with intra-abdominal infiltrates and abscesses through the introduction of the latest imaging methods and surgical technologies. Materials and methods. In the clinic of the Department of Surgical Diseases No 1, on the basis of the Surgery Center of the Kyiv City Clinical Hospital No. 1 from 2006 to 2019 218 patients with primary and secondary intra-abdominal infiltrates, abscesses and fluid formations were treated. The patients’ age ranged from 16 to 85 years. There were 107 (49.08%) male patients, 111 (50.92%) female patients. Depending on the time of hospitalization (by years), the patients were divided into two groups: the control group (CG) (2006–2012) 117 (53.67%) patients and the study group (SG) (2013–2019) 101 (46.33%) patients. The SG used the latest imaging technologies and improved methods of surgical treatment. Results. The patients were divided into two groups: primary in 191 (87.61%) and secondary postoperative infiltrates and abscesses in 27 (12.39%). The causes of primary infiltrates and abscesses were: complicated forms of appendicitis in 74 (33.94%), perforated stomach and duodenal ulcer in 48 (22.02%), complicated forms of cholecystitis in 69 (31.65%). Postoperative infiltrates and abscesses were observed in 27 (12.39%) patients who underwent urgent surgery: adgeolysis of adhesive ileus in 14 (6.42%) and complicated hernias of various localization in 13 (5.97%). Postoperative complications were diagnosed in 43 (19.72%) patients, of whom 34 (15.59%) from the surgical wound and 29 (15.18%) of the abdominal cavity, who required relaparotomy or laparoscopy, with destructive appendicitis in 10 (13.51%), perforated gastric ulcer and 12 duodenal ulcer in 6 (12.5%), destructive cholecystitis in 9 (13.04%), adhesive intestinal obstruction in 13 (19.12%) and with strangulated and complicated hernias in 14 (17.28%) of the examined patients. During relaparotomy, incompetence of the intestinal wall and intestinal sutures was established in 11 out of 32 patients, an ileostomy was imposed in 7, and cecostomy in 1 patient. Actually, in the control group, 8 (6.84%) patients died on the background of ongoing peritonitis, thrombosis of mesenteric vessels and multiple organ failure and concomitant ailments and in the study group 4 (3.96%) patients died. Conclusions. Surgical treatment is individualized depending on the disease, so with destructive appendicitis from 74 (38.74%) laparotomic in 42 (21.99%), laparoscopic in 32 (16.75%), and in 12 (6.28%) with conversion; perforated gastric ulcer and duodenal ulcer in 48 (25.13%) open laparotomy; with cholecystitis of 69 (36.13%) patients, 48 (25.13%) had laparotomy and 21 (11.00%) had laparoscopic examination. The use of the latest imaging and treatment technologies: Doppler ultrasonography, hydrojet scalpel and laparoscopy in 64 (33.51%), allowed to have better near and long-term results and to reduce postoperative mortality from 6.84% to 3.96%, with an average of 5.5%. The research was carried out in accordance with the principles of the Helsinki declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. The authors declare no conflicts of interests. Key words: destructive appendicitis, cholecystitis, perforated gastric ulcer and 12-duodenal ulcer, adhesive leakage, strangulated hernias, diagnosis and treatment.

scholarly journals SURGICAL TREATMENT OF PRIMARY INTRA-ABDOMINAL COMPLICATIONS: ABSCESSES AND INFILTRATES

2021 ◽  
Vol 8 (1) ◽  
pp. 30-36
Author(s):  
V. Skyba ◽  
V. Rybalchenko ◽  
O. Ivanko ◽  
N. Voytyuk ◽  
Dar Yasin Akhmed
Keyword(s):  
Duodenal Ulcer ◽  
Gastric Ulcer ◽  
Surgical Treatment ◽  
Underlying Disease ◽  
Control Group ◽  
Serous Membrane ◽  
The Third ◽  
Perforated Gastric Ulcer ◽  
Open Laparotomy ◽  
Male Patients

Purpose of the work. improving the results of surgical treatment of patients with primary intra-abdominal infiltrates and abscesses. Material and methods. From 2006 to 2019, 191 patients with primary intra-abdominal infiltrates and abscesses were treated. The patients' age ranged from 16 to 85 years. There were 96 male patients (50.26%), 95 female patients (49.74%). Results. The patients were divided into 3 subgroups depending on the underlying disease. The first group included 74 (38.74%) patients with destructive appendicitis, of which 39 (20.42%) were in the control group, and 35 (18.32%) were studied. The second group included 48 (25.13%) patients suffering from perforated gastric ulcer and 12 duodenal ulcer, of which the control group was 26 (13.61%), and the studied group was 22 (11.52%). The third group included 69 (36.13%) patients with cholecystitis, of which 37 (19.37%) were in the control group, and 32 (16.76%) were studied. All patients were operated on. Conclusions. Surgical treatment is individualized depending on the disease, so with destructive appendicitis from 74 (38.74%) laparotomic in 42 (21.99%), laparoscopic in 32 (16.75%), and in 12 (6.28%) with conversion; perforated gastric ulcer and 12 duodenal ulcer in 48 (25.13%) open laparotomy; with cholecystitis from 69 (36.13%) in 48 (25.13%) laparotomic and in 21 (11.00%) laparoscopically. The use of water-jet technologies in 64 (33.51%) patients made it possible to minimize damage to the serous membrane and cleanse the peritoneum from acquired formations.

scholarly journals Gastropleural fistula: a rare complication of a perforated gastric ulcer in a hiatus hernia

2021 ◽  
Vol 14 (7) ◽  
pp. e241315
Author(s):  
Samantha Ann Pellegrino ◽  
Henry RE Drysdale ◽  
George Kalogeropoulos
Keyword(s):  
Gastric Ulcer ◽  
Hiatus Hernia ◽  
Rare Complication ◽  
Perforated Gastric Ulcer ◽  
Gastropleural Fistula

Managing the complications of vagotomy and drainage

1969 ◽  
Vol 7 (25) ◽  
pp. 97-99
Keyword(s):  
Duodenal Ulcer ◽  
Gastric Ulcer ◽  
Small Bowel ◽  
Gall Bladder ◽  
Partial Gastrectomy ◽  
Specific Form ◽  
Metabolic Effects ◽  
Recurrent Ulcer ◽  
Selective Vagotomy ◽  
Postoperative Problems

Vagotomy, accompanied by either gastroenterostomy or pyloroplasty, has become the most commonly used operation for duodenal ulcer. A few specialised units prefer selective vagotomy which preserves the extragastric vagal fibres running to gall bladder, pancreas and small bowel.1 2 Some surgeons also use vagotomy to treat gastric ulcer.1–3 These procedures are at least as successful as partial gastrectomy,4 but the metabolic effects may be less severe. The main postoperative problems are recurrent ulcer and a specific form of diarrhoea.

Tension pneumothorax from a perforated gastric ulcer

1976 ◽  
Vol 63 (3) ◽  
pp. 245-247 ◽  
Author(s):  
I. N. Nayak ◽  
D. Lawrence
Keyword(s):  
Gastric Ulcer ◽  
Tension Pneumothorax ◽  
Perforated Gastric Ulcer

scholarly journals THE EFFECT OF CHRONIC HYPERGLYCEMIA ON THE STATE OF MUSCULOSKELETAL SYSTEM (LITERATURE REVIEW)

2021 ◽  
Vol 21 (1) ◽  
pp. 184-187
Author(s):  
A.O. Ponyrko
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Bone Tissue ◽  
Musculoskeletal System ◽  
Metabolic Disorder ◽  
Skeletal System ◽  
Complex Disorders ◽  
Chronic Hyperglycemia ◽  
Wide Range

Diabetes mellitus is a metabolic disorder that today has become a threatening problem for human health. Its prevalence has been constantly increasing throughout the world over the past decades. Diabetes mellitus is regarded as an incurable metabolic disorder characterized by hyperglycemia, which is caused by defects in insulin secretion. This disease annually affects almost 3% of the total population of the planet. Chronic hyperglycemia causes dysfunction of various organs of the body, such as the eyes, kidneys, heart, blood vessels, and nerves. The most common complications of diabetes include lesions of the vessels of the eye, kidneys, lower limbs and nervous system. A high level of glucose in the blood causes the development of a wide range of pathological disorders, which affect bones as well. Recent studies have shown that diseases of the skeletal system are often observed in diabetes mellitus. Speaking about the effect of hyperglycemia on bones, the development of osteopenia and osteoporosis should be noted. In this regard, an important area of research is to study changes in the bone tissue in patients with type 1 diabetes mellitus and the mechanisms that lead to disruption of bone structure and metabolism. The article highlights the pathophysiological mechanisms of hyperglycemia action in type 1 diabetes that explains complex disorders of the organs of the musculoskeletal system. The detrimental effect of hyperglycemia results in marked degenerative changes in bone cells. The pathogenic effect of hyperglycemia on bone tissue is manifested in a decrease in bone mineral density that is due to the lack of insulin and, as a consequence, significant metabolic disorders, a decrease in bone mass, inhibition of bone tissue formation, a significant decrease in the trace element composition of bone. The combination of these factors creates the appropriate pathomorphological basis for the development of diabetic osteopathy. The article highlights the mechanism of action of hyperglycemia on skeletal system in order to stimulate to a more detailed investigation of diabetes mellitus in experimental animals.

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