RESUMO
Complex clinical examination was done in 107 patients, in whom gastrointestinal hemorrhage (GIH) of various etiology, have had occurred. Special attention was drawn toward early conduction of esophagogastroduodenofibroscopy, as a leading instrumental method, permitting to reveal a GIH source, its character and degree of hemostasis in accordance to J. Forrest scale. The patients state severity while hemorrhage from the foregut presence was estimated in accordance to routine principles, depending on the circulating blood volume deficiency. The structure algorithm for the patients' management, in accordance to which treatment tactic must be selected individually, permitting to improve the quality of the medical help delivery for the patients, was elaborated.
Assuntos
Hemostase Endoscópica/métodos , Úlcera Péptica Hemorrágica/cirurgia , Úlcera Péptica/cirurgia , Duodenoscopia , Duodeno/irrigação sanguínea , Duodeno/patologia , Duodeno/cirurgia , Esofagoscopia , Esôfago/irrigação sanguínea , Esôfago/patologia , Esôfago/cirurgia , Feminino , Gastroscopia , Humanos , Masculino , Úlcera Péptica/complicações , Úlcera Péptica/diagnóstico , Úlcera Péptica/patologia , Úlcera Péptica Hemorrágica/diagnóstico , Úlcera Péptica Hemorrágica/etiologia , Úlcera Péptica Hemorrágica/patologia , Índice de Gravidade de Doença , Estômago/irrigação sanguínea , Estômago/patologia , Estômago/cirurgia , Resultado do TratamentoRESUMO
Microjejunostomy was performed to 12 patients in surgical department in 2013-2014yrs with the objective of decompression of initial portions of a small bowel and nutritivEesupport achievement. While performing primary operative intervention decompressiornwas applied in 4 patients, and while relaparotomy --n 8. Application of method of asmall bowel drainage have provided its adequate decompression and was not accom pnied by additional trauma of the structures drained. This method may constitutEealternative for duodenostomy.
Assuntos
Apendicite/cirurgia , Descompressão Cirúrgica/métodos , Jejunostomia/métodos , Peritonite/cirurgia , Adulto , Idoso , Apendicite/complicações , Apendicite/patologia , Drenagem/métodos , Duodenostomia/métodos , Feminino , Humanos , Intestino Delgado/patologia , Intestino Delgado/cirurgia , Masculino , Pessoa de Meia-Idade , Peritonite/etiologia , Peritonite/patologia , Estudos Retrospectivos , SuturasRESUMO
During 2011 - 2014 yrs in Surgical Clinic of The First City Clinic (Poltava) a relaparotomy was performed in 127 patients. There was established, that relaparotomy constitutes the only one procedure for such life threatening states, as intraabdominal bleeding, ileus in a decompensation stage, eventration, progressing peritonitis, abdominal compartment syndrome stages III - IV. The rate of relaparotomy application after performance of urgent operative interventions is bigger than after planned operations (ratio 4:1). Individual estimation of a state and choice of optimal surgical tactics during primary and secondary operative interventions are needed to improve the results of treatment.
