Congenital dysfibrinogenemia as a rare cause of recurrent gastrointestinal bleeding

<b>Introduction: </b>Gastrointestinal bleeding is a common disease that surgeons encounter in everyday clinical practice. It is most often easy to diagnose and treat. However, rare causes of bleeding can lead to delayed diagnosis and ineffective treatment. Dysfibrinogenemia is a qualitative fibrinogen disorder in which functional fibrinogen level is reduced with normal antigenic level. <br><b> Case report:</b> Herein we present the case of a 59-year-old female with recurrent gastrointestinal bleeds, that turned out to be an unusual manifestation of congenital dysfibrinogenemia. Detailed imaging and endoscopic diagnostics revealed portal hypertension with a non-bleeding 1-cm gastrointestinal stromal tumor and multiple angiodysplastic lesions in close proximity.

Possibilities and prospects of surgical treatment of submucosal uterine myoma

Objective. Analysis of current tendencies in the treatment of patients with submucosal uterine myoma. Results. Submucosal uterine myoma is often an indication for hysterectomy. At the same time, modern surgical methods allow performing organ-sparing interventions quickly and safely, including on an outpatient basis with the use of mini hysteroresectoscope. Accurate topographic diagnosis is an important condition for the successful implementation of organ-sparing treatment for submucosal myoma. When choosing diagnostic instruments, it is necessary to take into account their specificity and availability, which makes hydrosonography and hysteroscopy a priority, especially considering that endoscopic diagnostics can be supplemented by myoma resection, and the use of spectral analysis in image processing makes it possible to more accurately identify associated endometrial pathology. Conclusion. The use of mini-resectoscope (16 Fr) allows achieving a number of significant advantages in comparison with traditional hysteroresectoscopy. The use of spectral analysis in hysteroscopy provides more information about the state of the endometrium and intrauterine formations. Key words: intrauterine shaver, myomectomy, office hysteroresectoscopy, submucosal uterine myoma, spectral analysis

ENDOSCOPIC DIAGNOSTICS AND THERAPY OF CHEMICAL BURNS IN RESPIRATORY TRACTS

Results of endoscopic diagnostics and treatment of 58 victims with chemical burns of airways are reported. They made 16.9% of observations of all patients admitted to hospital with poisonings by cauterizing substances. Endoscopic and X-ray semiotics of airways chemical burns is reported. The incidence and severity of airways lesions in relation to the degree of esophagus chemical burns were assessed. It is established that burn laryngotracheo bronchitis became complicated by the development of pneumonia in 77.6% of observations , and in 6.9% by cicatricial narrowing of the trachea and bronchi. Localization and the development speed of infiltrative changes in lungs allow to assume that the aspiration of cauterizing liquids plays the key role in the pneumonia genesis. The therapeutic bronchoscopy included toilet bronchoscopy of the trachea bronchial tree with 0.01% solution of dioxydin and laser photo stimulation with a red- range low-energy laser. Therapeutic sessions were carried out 3 times a week. From 1 to 10 sessions were performed depending on the severity of airways chemical burns. Convalescence of all patients was achieved.