[Treatment of inflammatory complications of colic diverticular disease at the emergency surgical care hospital]. / Opyt lecheniia patsientov s vospalitel'nymi oslozhneniiami divertikuliarnoi bolezni obodochnoi kishki v statsionare neotlozhnoi khirurgicheskoi pomoshchi.

AIM: To assess an effectiveness of minimally invasive and laparoscopic technologies in treatment of inflammatory complications of colic diverticular disease. MATERIAL AND METHODS: The study included 150 patients who were divided into control and main groups. Survey included ultrasound, X-ray examination and abdominal computerized tomography. In the main group standardized treatment algorithm including minimally invasive and laparoscopic technologies was used. RESULTS: In the main group 79 patients underwent conservative treatment, minimally invasive (ultrasound-assisted percutaneous drainage of abscesses) and laparoscopic surgery that was successful in 78 (98.7%) patients. CONCLUSION: Standardized algorithm reduces time of treatment, incidence of postoperative complications, mortality and the risk of recurrent inflammatory complications of colic diverticular disease. Also postoperative quality of life was improved.

[The difficulties of diagnosis and treatment of non-occlusive mesenteric circulatory disorders].

AIM: To review one of actual problems of emergency surgery - diagnosis and treatment of patients with non-occlusive mesenteric circulatory disorders. MATERIAL AND METHODS: The article presents the clinical observations showing the ambiguity of clinical picture, features and challenges of diagnosis, treatment of disease and opportunities for positive outcomes. Diagnostic methods are x-ray, abdominal ultrasonography according to which acute abdominal ischemia may be assumed. However, in all unclear cases diagnostic videolaparoscopy is mandatory to determine further tactics. Unfortunately diagnostic videolaparoscopy is not always interpreted comprehensively and not a definitive method of diagnosis. Wide surgical access is usually necessary for non-occlusal acute violation of mesenteric circulation and volume of surgery varies from segmental to subtotal intestinal and colic resection with obligatory enteral intubation and decompression. Thus, complex pre- and postoperative treatment is required.

Neonatal manifestations of congenital dyserythropoietic anemia type I.

Congenital dyserythropoietic anemia type I is a rare inherited bone marrow disorder characterised by macrocytic anemia with pathognomonic morphological ultrastructural features in erythroid precursors. The disease is usually not diagnosed in the neonatal period. In a retrospective study of 31 patients we found that 17 were first seen in the neonatal age with significant anemia (birth hematocrit 0.34 +/- 0.07); 14 of the 17 infants also had early jaundice. Six infants were small for gestational age and two had syndactyly. Although rare, congenital dyserythropoietic anemia type I should be considered in the differential diagnosis of neonatal anemia.

[T-cell lymphoma].

8 patients with lymphoproliferative disorders of T-cell origin were diagnosed during the years 1985-1987. They included 2 cases of so-called Lennert's lymphoma, 1 case of T-cell lymphoma simulating malignant histiocytosis and 1 case of T-cell lymphatic lymphoma with splenic T-cell lymphoma which survived 10 years. The other cases presented with peripheral T-cell lymphomas. Immunologic typing of malignant lymphomas with cell suspensions is of diagnostic value.

Unusual clinical presentation of acute sarcoidosis.

A 16-year-old male developed fever and productive cough of 2 months' duration. Extensive search for an infectious process was negative. After appearance of knee joint effusion, a transbronchial biopsy through a fiberoptic bronchoscope revealed histological findings consistent with sarcoidosis. The patient recovered after a course of prednisone therapy. The atypical presentation of this systemic disease caused considerable delay in diagnosis and initiation of treatment.