scholarly journals ARROSIVE BLEEDING FROM THE APPENDICULAR ARTERY IN ACUTE DESTRUCTIVE APPENDICITIS

2021 ◽  
pp. 133-136
Author(s):  
A. V. Kapshitar ◽  
A. A. Kapshitar
Keyword(s):  
Acute Appendicitis ◽  
Research Methods ◽  
Antibacterial Therapy ◽  
Emergency Surgery ◽  
Clinical Case ◽  
Rare Complication ◽  
Abdominal Cavity ◽  
Favorable Outcome ◽  
Surgical Department ◽  
Prolonged Delay

Summary. Objective of the study: to present to the surgical community a rather rare complication of severe destructive appendicitis – arrosive bleeding and the cause of its development. Material and methods. Published a rare clinical case from prac-tice — the development of perforation of the appendix and arrosive bleeding from the appendicular artery in a patient with acute gangrenous appendicitis. Results and its discussion. The atypical course of acute appendicitis of undulating nature under the mask of acute adnexitis and antibacterial therapy has led to a prolonged delay with surgery in the surgical department. Only the appendicular abscess, which spontaneously opened into the abdominal cavity, made it possible to diagnose acute appendicitis and determine indications for emergency surgery, during which arrosive bleeding was diagnosed. The favorable outcome of the disease is due to the local purulent-necrotic process and small hemoperitoneum. Findings. Timely diagnosis of acute appendicitis, with the involvement of additional research methods in unclear cases, and subsequent appendectomy, are the prevention of a rather rare complication — arrosive bleeding from the appendicular artery in the development of severe complicated forms of acute destructive appendicitis.

scholarly journals CLINICAL OBSERVATION OF A FAVORABLE OUTCOME AFTER SEVERE INJURY DUE TO THE FALL FROM THE SIXTEENTH STOREY

2018 ◽  
Vol 22 (6) ◽  
pp. 323-329
Author(s):  
Vladimir G. Bagaev ◽  
A. V. Timofeeva ◽  
V. G. Amcheslavsky ◽  
T. F. Ivanova ◽  
M. V. Bykov ◽  
...  
Keyword(s):  
Medical Care ◽  
Emergency Surgery ◽  
Clinical Case ◽  
Clinical Observation ◽  
Favorable Outcome ◽  
Severe Injury ◽  
Critical Height ◽  
Childhood Injuries ◽  
Dwelling House ◽  
Combined Injuries

Introduction. Catatrauma is one of the main causes of childhood injuries and deaths in Russia. The severity of the condition of catatrauma is caused by combined injuries, high disability and lethality depend on them. Most often, children fall from the balconies of houses, windows, trees, and playgrounds. The purpose of the study was to show, on a clinical example, the case of a fall of a child from the height of the 16th storey of a dwelling house and the survival with a favorable outcome. Material and methods. The clinical example demonstrates the provision of medical care to a 5 years old child with catatrauma in a metropolis. After falling from a critical height (48 m) at the prehospital stage, he was assisted by ambulance brigades, and transportation was carried out by a helicopter. At the hospital stage, the victim was treated at the Research Institute of Emergency Surgery and Traumatology, where all departments of the clinic were involved. Results. This clinical case is unique in that the child, having fallen from the 16th sorey, from a height of more than 48 m, having received multiple combined injuries with an ISS score of 34 points, survived. An outcome was favorable due to the fact that the child was dressed in winter clothes with a jacket hooded over his head and fell into the snow, as well as coordinated actions of the services and units providing medical care at the prehospital and hospital stages in the metropolis. Conclusion. A favorable outcome after the child had fallen from a critical height, was affected by facts that both the child was dressed in winter clothes with a hood and a hat, put on the head, falling into the snow, and the coordinated activity of the structures and units participating in the prehospital and hospital stages of medical care.

scholarly journals A rare case of urinary bladder stone secondary to migrating Intra Uterine Device.

2019 ◽  
Vol 5 (1) ◽  
pp. 32-34
Author(s):  
Sonam Jamtsho
Keyword(s):  
Rare Complication ◽  
Abdominal Cavity ◽  
Bladder Stone ◽  
Surgical Department ◽  
Contraceptive Devices ◽  
First Case ◽  
Intrauterine Contraceptive ◽  
Systemic Side Effects ◽  
And Migration ◽  
National Referral Hospital

 Intrauterine contraceptive devices (IUCDs) is one of the most commonly used in Bhutan. IUCDs are effective, safe, cheap, and has minimal systemic side effects. One of the major but rare complications is perforation of uterus and migration into pelvic and abdominal cavity and organs. Migrating into urinary balder is a rare complication. We report the first case of bladder stone secondary to migrating Copper T in a 50-year-old female who presented to the surgical department of Jigme Dorji Dorji Wangchuck National Referral Hospital.

scholarly journals THE CASE OF DIFFICULTY DIAGNOSIS OF ACUTE APENDICITIS IN ATYPICAL POSITION ON THE APPENDIX ON THE BACKGROUND OF THE MALFORMATION OF ABDOMINALCAVITY

2015 ◽  
Vol 7 (1) ◽  
pp. 144-146
Author(s):  
M S Sultanov ◽  
A N Litvinov ◽  
M M Nakhumov
Keyword(s):  
Acute Appendicitis ◽  
Diagnostic Laparoscopy ◽  
Clinical Case ◽  
Abdominal Cavity

The article presents a clinical case of acute destructive appendicitis on the background of the anomalies of the abdominal cavity. This observation demonstrates the significant difficulties in the diagnosis of acute appendicitis occurring against the background of an atypical location of the appendix if you can not perform a diagnostic laparoscopy.

scholarly journals PROBLEMS OF ACUTE APPENDICITIS DIAGNOSTICS AND SURGICAL TREATMENT

2021 ◽  
pp. 95-99
Author(s):  
V. K. Churpiy ◽  
K. L. Churpiy
Keyword(s):  
Surgical Treatment ◽  
Acute Appendicitis ◽  
Sigmoid Colon ◽  
Abdominal Cavity ◽  
Fish Bone ◽  
Preoperative Period ◽  
Terminal Ileitis ◽  
Acute Calculous Cholecystitis ◽  
Surgical Department ◽  
Suspected Acute Appendicitis

Acute appendicitis is a "chameleon disease" that requires in many cases a complex differential diagnosis. Inflammation of the appendix is one of the most common surgical diseases. Difficulties in the verification of acute appendicitis, the severity of complications associated with late diagnosis indicate that the problems of diagnosis and treatment of this pathology has not lost its relevance. The most difficult question for the surgeon is to diagnose acute appendicitis in time and carry out surgical treatment, prevent all possible complications and minimize the frequency of removal of the unaltered appendix. The aim of the study to determine and systematize the causes of difficulties in diagnosing acute appendicitis at the preoperative stage. A retrospective analysis of 586 medical records of inpatients who were treated in the surgical department was performed. Among the operated 511 (87.2%) patients, the diagnosis of acute appendicitis before and after surgery coincided, which was confirmed morphologically. In 75 cases, which is 12.8%, the diagnosis of acute appendicitis had atypical symptoms or was masked by the clinic of another pathology. Observations of atypical cases of acute appendicitis in combination with other pathologies were the following diseases that occurred under the clinic signs, or combined with them: perforation of the small intestine with fish bone - 4 cases; perforation of Meckel's diverticulum - 2. In one case perforation by a fish bone, in another inflammation with its perforation. - terminal ileitis - 1; torsion and necrosis of the fatty suspension of the elongated sigmoid colon - 2; perforation of the diverticulum of the elongated sigmoid colon - 1, rupture of the ovarian cyst - 9 cases, including two children 13 and 17 years; piosalpinx - 2, 1 case of combination of acute calculous cholecystitis with gangrenous appendicitis, which was detected during the audit of the abdominal cavity; inflammatory infiltrate of the omentum - 3; torsion and gangrene of the omentum - 2, a combination of acute appendicitis with omentitis - 8 cases; combination of acute appendicitis with mesoadenitis - 39 cases; rupture of the spleen - 1. Conclusions: Under the clinic of acute appendicitis or in combination with it other acute diseases of the abdominal cavity can mask, up to 12.8%, which are difficult or in some cases impossible to diagnose in the preoperative period. One of the reasons for the difficulties of diagnosis is the omission by patients of anamnesis data regarding the onset and course of the disease, as well as alcohol consumption. Difficulties in diagnosis occur in children, especially young people, which is 61.3% of cases. The combination of acute appendicitis with mesoadenitis was observed in 6.6%. Among these patients, acetonemic syndrome was observed in 87.2% of cases. This group of patients is dominated by children. Gynecological diseases are disguised under the clinic of acute appendicitis in 1.9%, which requires a joint examination by a surgeon and obstetrician-gynecologist of patients with suspected acute appendicitis in the preoperative period. Deciding on surgical treatment for suspected acute appendicitis is a clinic of acute peritonitis, which was observed in 63.3%, requires proper clinical thinking of the surgeon combined with experience, laboratory and instrumental examination.

scholarly journals Esophageal injury during pulmonary vein isolation

2015 ◽  
Vol 18 (4) ◽  
pp. 188
Author(s):  
D. V. Losik ◽  
V. V. Shabanov ◽  
R. T. Kamiev ◽  
S. N. Artemenko
Keyword(s):  
Case Report ◽  
Pulmonary Vein ◽  
Pulmonary Vein Isolation ◽  
Clinical Case ◽  
Rare Complication ◽  
Esophageal Injury ◽  
Esophageal Wall

This clinical case report shows a rare complication following pulmonary vein isolation, with the esophageal wall injured during the procedure and a hematoma developed on the wall.

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 Perforation of the jejunum diverticulum: the role of CT examination

2019 ◽  
pp. 66-76
Author(s):  
I. V. Platitsyn ◽  
A. V. Kondratyev ◽  
A. V. Panin ◽  
E. M. Shubarkina ◽  
A. L. Maslov
Keyword(s):  
Small Intestine ◽  
Acute Abdomen ◽  
Research Methods ◽  
Clinical Case ◽  
Laparoscopic Resection ◽  
Surgical Intervention ◽  
Everyday Practice ◽  
Correct Interpretation ◽  
Common Causes

Uncomplicated diverticula of the small intestine are asymptomatic, extremely rare in everyday practice and, most often, are detected already with the development of complications such as perforation and abscess formation. Diagnosis of complicated diverticula of the small intestine is difficult due to many other, more common causes of acute abdomen, insufficient use of the capabilities of the methods of radiation diagnosis, the lack of application and correct interpretation of the results of instrumental and special research methods. The article presents a clinical case of perforation of the jejunum diverticulum. The results of effective MDCT diagnosis and successful surgical intervention are presented: laparoscopic resection of the jejunum with the formation of the primary hardware intracorporeal enteroentero-anastomosis side by side. 

scholarly journals Unligature method of laparoscopic appendectomy in children

2020 ◽  
Vol 10 (1) ◽  
pp. 53-58
Author(s):  
Vyacheslav G. Svarich ◽  
Evgeniy G. Perevozchikov ◽  
Ilya M. Kagantsov
Keyword(s):  
Postoperative Complications ◽  
Acute Appendicitis ◽  
Laparoscopic Appendectomy ◽  
Open Appendectomy ◽  
Operation Time ◽  
High Energy ◽  
Inflammatory Infiltration ◽  
Surgical Department ◽  
Clinical Hospital ◽  
Digital Assessment

Aim. On the basis of the accumulated clinical material to show the possibility of a ligature-free method of laparoscopic appendectomy in children. Materials and methods. From 2000 to 2019, 2044 children with acute appendicitis were treated in the surgical department of the Republican childrens clinical hospital in Syktyvkar. Of these, 651 patients had an open appendectomy with treatment of the stump of the vermiform process by the submersible method, 1363 children had a laparoscopic appendectomy with ligature treatment of the stump of the process, and 32 patients had their first non-ligature laparoscopic appendectomy with the intersection of the vermiform process with the Ligasure device. Results. On average, surgery for ligature-free laparoscopic appendectomy lasted 7 3 minutes less than for laparoscopic appendectomy using the ligature method for treating the stump of the worm-like process. Experimentally, it was found that this method of appendectomy should not be used when the thickness of the worm-like process is more than 1.5 cm, with pronounced inflammatory infiltration of the caecum dome and perforation at the base of the process. With ligature-free appendectomy, the operation time was reduced. In the period from 1 to 6 months, there were no intra-abdominal postoperative complications associated with the new method of surgery. Conclusion. Ligar-free laparoscopic appendectomy in children using modern high-energy platforms with a digital assessment of the degree of tissue coagulation readiness made it possible to avoid intraoperative and postoperative complications, simplify the technique of its implementation, and reduce the time of surgery.

scholarly journals Method of spleen reduction in laparoscopic splenectomy in children with hereditary autoimmune hemolytic anemia

2020 ◽  
Vol 10 (4) ◽  
pp. 429-433
Author(s):  
Vyacheslav G. Svarich ◽  
Ilya M. Kagantsov ◽  
Violetta A. Svarich
Keyword(s):  
Surgical Treatment ◽  
Hemolytic Anemia ◽  
Autoimmune Hemolytic Anemia ◽  
Laparoscopic Splenectomy ◽  
Surgical Intervention ◽  
Abdominal Cavity ◽  
Operation Time ◽  
Spleen Tissue ◽  
Surgical Department ◽  
Large Size

Purpose. This study aimed to improve the results of surgical treatment of children with hereditary autoimmune hemolytic anemia by laparoscopic splenectomy. Materials and methods. In the period from 1991 to 2020, a total 47 patients with hereditary autoimmune hemolytic anemia were treated in the surgical department of the Republican Childrens Clinical Hospital of Syktyvkar. Splenectomy was performed by the open method in 25 children, and laparoscopic method in 22 patients. Since 2019, the method of spleen reduction during laparoscopic splenectomy has been used in 3 patients when the large size of the mobilized spleen does not correspond to the size of the endoscopic container. Results. On average, surgical intervention using the above-described method of spleen reduction lasted for 19 2 min lesser than with laparoscopic splenectomy without the above method, due to the possibility of removing a significantly smaller volume of spleen tissue from the endoscopic sac outside the abdominal cavity. However, the most important achievement was the almost complete elimination of the risk of getting free fragments of a pathologically altered spleen with its possible replantation and recurrence of the clinic of autoimmune hemolytic anemia. The postoperative period was smooth, and all patients were discharged at their place of residence 7 days after the laparoscopic splenectomy. Intra-abdominal complications and relapses of the disease associated with the above-described method of operation did not occur in any patient within 612 months postoperative. Conclusion. The proposed method of spleen reduction during laparoscopic splenectomy made it possible to avoid relapses of the disease, reduce the operation time, as a result, improved the results of surgical treatment in children with hereditary autoimmune hemolytic anemia.

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