[Clinical and ultrasonic diagnosis of colon diverticulitis and its complications].

Clinical presentations and ultrasonic criteria of colon diverticulitis and its complications in 31 patients (14 men, 17 women) were analyzed. Diverticulitis of the colon was diagnosed at ultrasonic examination (USI) in 23 (74.2%) of 31 patients. USI was carried out with device "SONOLINE Elegra" (Siemens) with convex and linear multifrequency sensors (2-9 MHz). All the patients were examined in scanning regimens of grey scale, tissue harmony, color doppler and energetic Doppler. In some patients with pain syndrome and absence of diverticulitis symptoms according to trans abdominal ultrasonic examination additional transrectal and transvaginal scanning were performed. Clinical picture and ultrasonic criteria of colon diverticulitis and its complications as well as limitations of ultrasonography in diagnosis of this disease were analyzed. In 8 (25.8%) patients false-negative results were seen, there were no false-positive diagnostic mistakes.

[Surgical treatment of perforated gastroduodenal ulcers]. / Khirurgicheskoe lechenie probodnykh gastroduodenal'nykh iazv.

Experience in surgically treating 820 patients aged 15 to 83 years who had perforated gastroduodenal ulcers is summarized. In 576 (70.2%) patients the perforated hole was sutured. Thirty-four (4.2%) patients underwent gastrectomy and 210 (25.6%) had vagotomy with drainage operation on the stomach. After surgery 39 (5.6%) patients died. Mortality rates after ulcer suturing, gastrectomy, and vagotomy with gastric drainage were 6.2, 2.7, and 0.9%, respectively. Recurrent ulcer occurred in 57.3% after ulcer suturing, in 2.9% after gastrectomy, and in 9% after gastric drainage vagotomy. By taking into consideration the high rate of recurrent ulcers following palliative interventions, the author proposes to expand indications for radical surgery in patients with serous and serofibrinous forms of general peritonitis in the reactive phase.

[Organization of medical services for the victims of the earthquake in the city of Spitak, Armenian S.S.R]. / Organizatsiia okazaniia meditsinskoi pomoshchi postradavshim v épitsentre zemletriaseniia--g. Spitake Armianskoi SSR.

Sanitary losses in the city of Spitak were about 47.8%, injures of the middle and critical degree being diagnosed in 9.5%. During the first period (from December 9 to 14, 1988) patients admitted to the hospitals predominantly had traumas of the head, chest, extremities, vertebral column (86.3%). The crush syndrome and position compressions and their combinations with total cooling during this time were diagnosed in 61 victims (19%), and during the whole period of work--in 63 (7.6%). Success of treatment of the patients with this pathology was promoted by their having obtained qualified surgical and anesthesiological aid before evacuation to medical institutions of the Center in full value in combination with temporary admittance to the hospital at an average for 12-18 hours up to complete arrest of shock. During the first steps of evacuation the amputation of extremities was fulfilled in 3 cases.

[Morphologic characteristics of the mucous membrane of the stomach and duodenum in patients with acute complications of gastroduodenal ulcers after surgical procedures]. / Morfologicheskaia kharakteristika slizistykh obolochek zheludka i dvenadtsatiperstnoi kishki u bol'nykh s ostrymi oslozhneniiami gastroduodenal'nykh iazv posle khirurgicheskikh vmeshatel'stv.

Patients with acute complications of gastroduodenal ulcers are characterized by common morphological alterations in mucous membranes of the stomach and duodenum which consisted in higher or normal content of parietal, main and EcI-cells, substantial deficiency of Ec-cells as well as in progressively decreased mucin formation from proximal portions of the stomach to distal ones with its lowest level in the duodenum.

[Unsolved problems in the surgical treatment of complicated ulcers of the stomach and duodenum]. / Nereshennye voprosy operativnogo lecheniia oslozhnennykh iazv zheludka i dvenadtsatiperstnoi kishki.

The article generalizes an experience of a number of surgical collectives of the Military Medical Academy with the surgical treatment of complicated gastroduodenal ulcers by organ-preserving operations. The authors recommend wider use of such interventions in acute complications of ulcer disease (perforation and bleedings). It is important to abstain from performing such operations on planned patients with very high gastric secretion in order to decrease the amount of recurrences after vagotomy, to choose an adequate draining operation in stenosis. In young patients vagotomy should be combined with antrumresection.

[Surgical treatment of "silent" ulcers of the stomach and duodenum complicated by perforation]. / Khirurgickoe lechenie "Nemykh" iazv zheludka i dvenadtsatiperstnoi kishki, oslozhnennykh perforatsiei.

Patients with perforating "silent" ulcers and patients with continuous ulcer histories must be subjected to similar surgical treatment. In most cases it may be truncal vagotomy with draining operation on the stomach. Operation of suturing the perforating ulcer is thought to be expedient in patients with acute ulcers (they make up not more than 25%), with severe concomitant diseases, in the terminal phase of diffuse peritonitis and when performed by surgeons with insufficient experience.

[Status of the immune system in acute gastrointestinal hemorrhages from chronic gastroduodenal ulcers]. / Sostoianie immunnoi sistemy pri ostrykh zheludochno-kishechnykh krovotecheniiakh iz khronicheskikh gastroduodenal'nykh iazv.

Based on a comparative study of indices of the cell and humoral immunity in patients with different degree of blood loss in the posthemorrhagic and postoperative periods the author has established that they are characterized by a stable proportion of different populations of lymphocytes with the deficiency of immune competent cells and increased content of lymphocytes without T and B lymphocyte specific markers. The concentration of 3 main classes of immunoglobulins G, A and M is maintained within normal limits even at severe blood loss which discloses great compensatory abilities of the immune system.

[Condition of the operated-on stomach in patients with acute complications of gastroduodenal ulcers]. / Sostoianie operirovannogo zheludka u bol'nykh s ostrymi gastroduodenal'nykh iazy.

On the basis of results of examination of 1094 patients the authors consider that normal functioning of the operated stomach is ensured due to adequate acid-formation within the limits of hypo- and normochlorhydria, normal evacuatory function and absence of pronounced gastric alterations of the mucosa. Functional disorders and severe postoperative syndromes were most frequently observed in patients after extensive gastric resections which is associated with the suppression of compensatory-adaptational mechanisms due to cutting of both endocrine and neurocrine regulation. The best functional results in the remote period were obtained after selective proximal vagotomy without draining operations.

[Endoscopic evaluation of the status of the stomach in patients after ulcer surgery]. / Endoskopicheskaia otsenka sostoianiia operirovannogo zheludka bol'nykh s iazvennoi bolezn'iu.

On the basis of the investigation of nearest and long-term clinical results of the operative treatment of acute complications of gastroduodenal ulcers and results of endoscopic examinations of 309 patients a conclusion is made of the expediency of the endoscopic examination in the nearest postoperative period. The group of patients with good results should include patients having no complaints, with normal functions of the operated stomach, without duodeno-jejunogastric reflux and pronounced gastric changes.