ABSTRACT
18 patients with complicated forms of intestinal amebiasis were operated on acute appendicitis, liver abscess or total necrotic colitis. Appendectomy, abscess drainage and colon resection were performed respectively. There were no postoperative deaths. Features of amebic appendicitis and total necrotic amebic colitis are described using clinical cases demonstrations. Recommendations for the treatment of these forms of amebiasis are given.
Subject(s)
Colectomy/methods , Colitis/surgery , Colon/pathology , Dysentery, Amebic/complications , Adult , Animals , Colitis/diagnosis , Colitis/etiology , Colon/parasitology , Colon/surgery , Diagnosis, Differential , Dysentery, Amebic/diagnosis , Dysentery, Amebic/surgery , Emergencies , Entamoeba histolytica/isolation & purification , Humans , Intestinal Mucosa/parasitology , Intestinal Mucosa/pathology , Male , Middle Aged , Necrosis/diagnosis , Necrosis/etiology , Necrosis/surgery , Rupture, SpontaneousABSTRACT
The article is dedicated to bacterial translocation under the conditions of acute small and large bowel obstruction, studied in experiment using bacteriological methods. The degree of contamination of internal organs, blood, and peritoneal exudate in the dynamics of the pathological process was determined. The study found that the use of allopurinol, a xanthine oxidase inhibitor, reduced the intensity of bacterial translocation.
Subject(s)
Ascitic Fluid/microbiology , Bacterial Translocation , Blood/microbiology , Intestinal Obstruction/microbiology , Liver/microbiology , Lung/microbiology , Spleen/microbiology , Acute Disease , Allopurinol/administration & dosage , Allopurinol/pharmacology , Animals , Bacterial Translocation/drug effects , Bacteriological Techniques , Enzyme Inhibitors/administration & dosage , Enzyme Inhibitors/pharmacology , Female , Intestinal Mucosa/microbiology , Intestine, Large/microbiology , Intestine, Small/microbiology , Male , Rabbits , Time Factors , Xanthine Oxidase/antagonists & inhibitorsABSTRACT
Experience of complex treatment of 137 patients with complicated postnecrotic pancreatic cysts (PPC) is analyzed. Indications to different surgical methods are formulated differentially depending on complications of cysts, localization, sizes, "maturity" of cyst walls, communication with main pancreatic duct. Treatment of festered PPC should be started with minimally-invasive methods; at negative result the omentobursocystostomy with staged endoscopic sanations should be done that permits to decrease the number of postoperative complications and to reduce lethality from 14.3 to 4.5%. Resection of pancreas along with cyst is the operation of choice at pancreatic cysts complicated with bleeding; lethality has been reduced from 28.6 to 5.6%. Perforation of cysts into abdominal cavity is the indication to omentobursocystostomy with staged sanations of omental bursa, perforation into pleural cavity -- to distal resection of pancreas.
Subject(s)
Cholangiopancreatography, Endoscopic Retrograde , Magnetic Resonance Imaging , Pancreatectomy/methods , Pancreatic Cyst/diagnosis , Pancreatic Cyst/surgery , Pancreatitis, Acute Necrotizing/complications , Diagnosis, Differential , Follow-Up Studies , Humans , Omentum/surgery , Retrospective Studies , Treatment OutcomeABSTRACT
The data on the results of combined treatment of 540 patients with diabetic osteoarthropathies (DOAP) complicated by pyonecrotic lesions of the feet (PNLF) are presented. The authors classification of these lesions is proposed which considers location and the stage of the disease. Surgical treatment was used in 387 (71.6%) patients. The analysis of the clinical experience in surgical treatment and the results obtained in patients with DOAP and PNLF allouvs to subdivide surgical procedures in the patients in to the following categories: 1) the initial prophylaxis of development of pyonecrotic processes; 2) measures of secondary prophylaxis of the progression of pyonecrotic processes; 3) amputation of the shin and the thigh. As a result of the complex of curative and prophylactic measures, comprizing surgical treatment, the number of favourable results of treatment in patients of the lest group increased by 24%, and the number of unfavourable outcomes decreased by 25%, the mortality rate in the test group lowered 2, 4 times.
