[Severe and complicated forms of chronic pancreatitis]. / Tiazhelye i oslozhnennye formy khronicheskogo pankreatita.

A total of 437 patients with chronic pancreatitis (CP) were examined. The authors detected interstitial or acute, parenchymal or recurrent, hyperplastic or pseudotumorous, and cystic variants in 91 (20.8%), 218 (49.9%), 78 (17.8%), 22 (5.1%), and 28 (6.4%) patients, respectively, Severe types due to the permanent pain syndrome, substantial weight loss and overall intoxication phenomena were seen in 21.5%. Complications of chronic pancreatitis were revealed in 32.3%. Pyoseptic complications (11.2%), anicteric cholestasis (8.5%), subhepatic portal hypertension (8.0%), cholestatic jaundice (7.8%) were most common. Immunodeficiency states developed with long-term treatment of CP. A small portion (0.9%) of patients with CP developed pancreatic carcinoma. 3% of patients had deaths directly due to the active course of the disease whose causes were pyoseptic processes, pancreatic carcinoma and profuse hemorrhages from exulcerations of the duodenal postbulbar part.

[The clinical picture and diagnosis of pancreatic carcinoma]. / K klinike i raspoznavaniiu kartsinomy podzheludochnoi zhelezy.

A total of 97 patients with pancreatic carcinoma were examined with sonography, computed tomography of the pancreas and endoscopy of the stomach and duodenum. The tumor involved mainly the head of the pancreas in 69 (71.1%), the body in 21 (21.7%) and the tail in 7 (7.2%) patients. Two basic types of the disease were identified: disseminated in 83 patients and rare in 14 patients. The disseminated type included a central (45 patients) and a peripheral (38 patients) variant. The latter is classed as peripheral (n = 30) and paraduodenal (n = 8). The rare types included masked variants (n = 6), miniblastomas (n = 3), megablastomas (n = 2) of the pancreas, as well as thrombotic variants of the disease (n = 3). The highest diagnostic value of sonography and computed tomography was observed in intrinsic peripheral variants of carcinoma. Gastroduodenal endoscopy along with biopsy of suspected segments is highly diagnostic in paraduodenal variants of the disease.

[The classification of chronic pancreatitis]. / O klassifikatsii khronicheskogo pankreatita.

To make the II Marseilles Classification of Pancreatitis more applicable to everyday clinical practice, a new systemic approach is suggested basing on clinical, laboratory, CT and ultrasound evidence. Upon examination of 182 chronic sufferers with pancreatitis, interstitial--edematous, parenchymatous, fibrous--sclerotic (indurative), hyperplastic (pseudotumorous) and cystic variants of the disease were established in 34.6%, 30%, 21.1%, 4.4% and 9.9%, respectively. Clinical features typical for each variant of the disease and most common complications are reviewed.

[Clinico-instrumental methods in the diagnosis and treatment of acute pancreatitis]. / Kliniko-instrumental'nye metody v diagnostike i lechenii ostrogo pankreatita.

Under analysis were diagnostic possibilities of clinico-instrumental methods in examination of 397 patients with acute pancreatitis. The integral method of examination included a general rentgenological examination, angiography, laparoscopy as well as echography and computer tomography. The reliable diagnostics of acute pancreatitis is known to be very complicated and requires a skillful combination of various research methods. The most rational scheme of the examination of patients suspected for acute pancreatitis is proposed.

[Use of computerized tomography and echography in the diagnosis and treatment of abscesses of the abdominal cavity and retroperitoneal space]. / Ispol'zovanie kompíuternoi tomografii u ékhografii v diagnostike i pri lechenii abstsessov organov briushnoi polosti i zabriushinnogo prostranstva.

An analysis of complex use of computer tomography and echography for diagnostics, aimed biopsy and following measures in 32 patients with foci of purulent infection in organs of the abdominal cavity and retroperitoneal space has been made. In 11 patients with small abscesses not more than 5 cm in diameter percutaneous aimed punctures of the pus cavity were fulfilled followed by the aspiration of the content and introduction of an antibiotic. In 21 patients percutaneous drains were introduced into the abscesses by Seldinger's method or through a trocar. Curative punctures and percutaneous drainage in 85.7% of the patients gave successful results.

[Diagnostic and therapeutic punctures in pulmonology]. / Diagnosticheskie i lechebnye punktsii v pul'monologii.

The paper is concerned with an analysis of combined use of modern methods of diagnostic imaging for spot biopsy and therapeutic manipulations in 274 patients with various chest diseases. Morphological diagnosis was verified in 252 of 274 examined patients (91.9%). X-ray or CT-assisted therapeutic manipulations with sanitation and drainage of pathological cavities were performed in 12 patients with pulmonary and mediastinal abscesses.