Damage to the diaphragm domes followed by the formation of false diaphragmatic hernias (FDH) occurs with closed and open trauma to the chest and/or abdomen. In this case, the mobile organs of the abdominal cavity, being uncovered by the parietal peritoneum, move to the pleural cavity and, with a small defect in the diaphragm, can be infringed up to necrosis of the organ wall. The rare occurrence of such pathology, the paucity of clinical symptoms, explains the high error rate in diagnosis, especially in primary health care. We have experience in two clinics over 34 years in the treatment of 12 patients with FDH. The left dome was damaged in 10 patients, the right dome in two. The age of damage to the diaphragm ranged from several hours to 7 years. Five clinical examples are presented, combined with the late diagnosis of the disease, the difficulties of diagnosis, even in a clinic using modern imaging tools. All patients are operated on both as planned and as an emergency. Endovideosurgical technologies for diagnosis and treatment are used only in 2 patients. 2 (16.67 %) patients died with a false diaphragmatic hernia due to a severe closed injury against the background of traumatic and hemorrhagic shocks. Conclusions. A clear explanation of the origin of scars on the skin of the chest and abdomen, clarification of the mechanisms and severity of closed injuries in the https://panor.ru/articles/osobennosti-diagnostiki-i-lecheniya-lozhnykh-posttravmaticheskikh-diafragmalnykh-gryzh/92437.html
Introduction. The hereditary tendency to thrombosis in children has been studied for the past 20 years due to molecular genetics. Currently, about 40 point mutations are known.Purpose. The article presents a clinical case taken from the authors’ practice which demonstrates thrombophilia complications in a child.Material and methods. A 12-year old girl was admitted to the registration department of the Regional Children’s Clinical Hospital (Chita) with abdominal pain and multiple vomitings. The complete blood count (CBC) revealed a marked hemoconcentration. Thrombophilia was diagnosed before the patients was hospitalized.Results. The performed surgical treatment was made by stages because of the extended necrotic lesion of the intestine. The testing of genetic polymorphism associated with thrombophilia risks revealed risk alleles FGB*455GA in the patientConclusion. The given article describes specific manifestations of gastrointestinal tract lesion, difficulties in diagnostics and care of complications in a patient with thrombophilia.
The aim of the study was to reveal the effect of sodium hypochlorite (HCH) solution at concentrations of 0.022%, 0.045% and 0.09% on the morphology of the intestinal wall and peritoneum during peritonitis in the experiment. Materials and methods. The study was carried out on 72 infertile sexually mature rats of both sexes weighting 190-250 g. The animal under ether anesthesia was performed laparotomy and modeling peritonitis according to the method by M.A. Magomedov. On day 1, all rats were irrigated with sodium hypochlorite solution at different concentrations (5 min). Selection of the material for study (part of the intestine) was carried out on the 1, 3 and 7th day of the experiment. Results. Sodium hypochlorite (0.022% and 0.045%) have not a proper antiseptic effect on microorganisms in secondary peritonitis. The HCH solution (0.09%) produces a sufficient bacterial and detergent effect, but contributes to secondary damage to abdominal tissues. Conclusions. 1. As an antiseptic can be recommended 0.09% solution of sodium hypochlorite with an exposure of 3-5 minutes to prevent the development of peritonitis 2. The use of low concentrations of sodium hypochlorite is possible for the purpose of mechanical cleaning of the abdominal cavity.
Treatment of the «difficult» stump of the duodenum occurs during peptic ulcer surgery. More than 340 methods of its suturing are known. When processing the «difficult» duodenal stump in the examples presented in the paper, the author’s method was used (patent No. 2696656 dated 08/05/2019).
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