RESUMEN
An algorithm has been developed for radiation diagnosis of small bowel obstruction, which involves abdominal X-ray and ultrasound studies at the first stage and radionuclide evaluation of gastrointestinal transit, by using 100-150 ml of aqueous 99mTc-technefite or 99mTc-bromeside solution in a dose of 50-100 MBq (radiation load 0.7-1.4 MeV) per os. The sensitivity, specificity, and diagnostic efficiency of the whole radiation diagnostic complex and each procedure separately were determined by the results of examination in 180 patients with suspected small bowel obstruction, of whom 104 patients were operated on, but obstruction ceased during medical treatment. Inclusion of the radionuclide technique into the diagnostic complex involving plain radiography and ultrasonography was shown to enhance diagnostic efficiency up to 97-98%.
Asunto(s)
Obstrucción Intestinal/diagnóstico por imagen , Intestino Delgado/diagnóstico por imagen , Estómago/diagnóstico por imagen , Diagnóstico Diferencial , Femenino , Estudios de Seguimiento , Tránsito Gastrointestinal/fisiología , Humanos , Masculino , Persona de Mediana Edad , Compuestos de Organotecnecio , Radiografía , Cintigrafía , Reproducibilidad de los Resultados , UltrasonografíaRESUMEN
Results of the treatment of 90 patients with generalized peritonitis and syndrome of intestinal insufficiency were analyzed. In the study group (45 patients) enteral administration of 1% pectin solution and glutamin solution (15-30 g/day) were included in combined therapy. Clinical and laboratory control, radiation monitoring and bacteriological studies carried out for evaluation of efficacy of therapy established. A decrease of endogenous intoxication and time of repair of functional activity of the gastrointestinal tract, immunomodulation, normalization of microbiocenosis of the small intestine. This therapy diminishes the number of complications and lethality.
Asunto(s)
Obstrucción Intestinal/dietoterapia , Obstrucción Intestinal/etiología , Peritonitis/complicaciones , Glutamina/uso terapéutico , Humanos , Intestino DelgadoRESUMEN
From 1980 five hundred and seventy-three patients underwent surgery for occlusive obstruction of the colon (OOC). Radical surgeries (left-sided hemicolonectomy, Hartman's surgery, subtotal colonectomy) were performed in 440 (77%) patients, 133 (23%) patients underwent palliative surgeries. One hundred and sixty-one patients of radically operated underwent one-stage surgeries (93 right-sided hemicolonectomies and 68 subtotal colonectomies). Postoperative lethality after radical surgeries was 16.5%. Postoperative lethality, time of hospital stay, rate of postoperative complications after Haptman's surgery and subtotal colintcyomy don't differ, but patients after subtotal colonectomy don't require reconstruction surgery.
Asunto(s)
Colon/cirugía , Procedimientos Quirúrgicos del Sistema Digestivo , Obstrucción Intestinal/cirugía , HumanosRESUMEN
Thirty-eight patients with mushroom (Paxillus involutus and Paxillus atrotomentosus) poisoning were treated. Slight poisoning (acute gastroenteritis) was diagnosed in 17 patients, medium-severe in 13, severe in 6, and extremely severe in 2 patients. Changes in the LPO-AOD system correlated with the severity of hepatorenal involvement. The treatment included hepatotropic therapy; patients with acute renal failure were treated by hemodialysis. Paxillus mushrooms induced functional evacuatory disorders in the small intestine. Eleven patients with adhesions in the abdominal cavity developed ileus. Two patients died: a man aged 26 years after eating fried (not boiled) mushrooms and a woman aged 76 years with ileus with symptoms of multiple organ dysfunction. The rest patients were discharged from hospital in satisfactory condition. Clinical course of poisoning with Paxillus mushrooms is discussed.