Lung Abscess and Gangrene: Evolution of Treatment Methods

Ясногородский, О. О.; Gostishchev, V K; Shulutko, A M; Пинчук, Т. П.; Struchkov, Iu V; Taldykin, M. V.; Насиров, Ф. Н.; Mochalov, Vadim

doi:10.18484/2305-0047.2020.2.150

Cited by 4 publications

(1 citation statement)

References 5 publications

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“…мультиспиральная компьютерная томография (мскт) органов грудной клетки (оГк) обладает значительно более высокими диагностическими характеристиками, чем рентгенография [7]. Это позволяет установить наличие некроза и гнойного расплавления легочной ткани, в зоне пневмонической инфильтрации выявляют однородный безвоздушный участок затемнения, часто округлой формы, лишенный просветов бронхов.…”

Section: What This Paper Addsunclassified

Angiopulmonography With Nitroglycerin Test in the Diagnosis of Acute Infectious Lung Destruction

Petukhov¹,

Derkach²,

Ермашкевич³

et al. 2021

Novosti Khirurgii

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Objective. To develop a method for additional and differential diagnosis of acute infectious lung destruction (AILD) based on angiopulmonography with the nitroglycerin test. Methods. Angiopulmonography with the nitroglycerin test was used in 10 patients with suppurative diseasesof thelung and pleura for additional and differential diagnosis of AILD The method was used in such situations when chest computed tomography did not allow to determine unambiguously the presence and / or prevalence of necrosis of the lung parenchyma. Results. In 3 patients with the lung abscess, a clear restriction of the decay cavity was registered with the preservation of the main blood flow and weakening of the parenchymal phase of the blood circulation along the periphery of the destructive area. During the nitroglycerin test performance there was no change in the filling of the microvascular bed with contrast along the periphery of the decay cavity, which made it possible to determine the presence of parietal sequesters. According to the results of the study, the lung gangrene was diagnosed in 6 patients. At the same time, two variants of circulatory disorders were noted: the first - with preservation of the blood flow through the main vessels and with the absence of a parenchymal phase in the lesion focus, the second - with the violation of the main blood flow. In the affected area no change in blood flow was observed after the nitroglycerin test performance. Similar results of the study indicated the development of necrosis of the pulmonary parenchyma, which was subsequently confirmed during the operations performed. In the site of inflammatory infiltration of the pulmonary parenchyma with preserved main blood flow, the depletion of the parenchymal phase of blood circulation was determined, but after the nitroglycerin test, a pronounced enrichment of the vascular architecture to the parenchymal phase in the pneumonia affecting part of the lung was noted. Conclusion. It has been established that AILD is characterized by irreversible changes in the vascular bed of the lung parenchyma in the lesion focus. Angiopulmonography with the nitroglycerin test is considered to be an additional highly informative method improving the early and differential diagnosis of AILD in difficult clinical situations. What this paper adds It has been found out that during angiopulmonography the areas of pulmonary necrosis are characterized by the absence of a vascular pattern with or without disturbance of the blood flow through the segmental arteries. At the same time, in contrast to the foci of pneumonia, the nitroglycerin test is not accompanied by an evaluation of the filling of the pulmonary vascular bed in the affected area, i.e. blood supply disorders are irreversible. Thus, based on an assessment of the nature and reversibility of the blood flow disturbances in the affected lung, it is possible to carry out differential diagnosis of the early stages of acute infectious lung destruction (AILD) and pneumonia.

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Section: What This Paper Addsunclassified

Angiopulmonography With Nitroglycerin Test in the Diagnosis of Acute Infectious Lung Destruction

Petukhov¹,

Derkach²,

Ермашкевич³

et al. 2021

Novosti Khirurgii

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Clinical and radiological variants of lung damage in the infection caused by staphylococcus aureus

Винокуров

Сергеевич²,

Smirnova

et al. 2021

Journal of Clinical Practice

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Despite the high level of modern technologies in the field of laboratory methods and imaging of the respiratory system, the problem of early and accurate differential diagnosis of inflammatory lung diseases remains important in practical medicine. It leads to improved treatment results and a reduction in the number of complications (pleural empyema, fistulas, mediastinitis, sepsis, etc.), and in some cases allows to suspect the presence of a primary purulent source in the body, as in the case of septic pulmonary embolism. The review examines the features of S. aureus as a pathogen of lung diseases, relevant epidemiology, pathogenesis, clinical features and imaging diagnostics of various types of inflammatory changes in the lungs with a focus on destruction.

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Outpatient diagnosis of endogenous intoxication in surgery

Solomakha

Vlasov

Gorbachenko

2022

Ambulatornaya khirurgiya

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Introduction. In recent years, there has been an increase in the number of patients with purulent surgical diseases with severe endogenous intoxication and renal dysfunction. The problem of early diagnosis of purulent diseases is still not completely solved. The health systems of developed industrial Western countries do not always manage to provide all citizens with adequate high-quality medical care. This is due to the current health crisis. The problems of diagnosis, treatment, prevention and prediction of purulent diseases in surgery can be solved thanks to advanced digital technologies.Aim of the study. To develop a diagnostic method for early detection of endogenous intoxication in outpatient surgery.Materials and methods. We created three groups of observations for the design of a neural network system for the diagnosis of endogenous intoxication syndrome and chronic kidney disease. In the first group, the hematological parameters of 150 healthy people were studied. In the second group, the hematological parameters of 40 patients with chronic kidney disease without chronic kidney failure were studied. The third group included 84 patients with chronic kidney disease and end-stage chronic kidney failure. The following 25 laboratory parameters were studied: hemoglobin, red blood cells, color index, white blood cells, rod-shaped neutrophil white blood cells, segmental neutrophil white blood cells, eosinophils, basophils, lymphocytes, monocytes, ESR, total protein, albumins, urea, creatinine, bilirubin, beta-lipoproteins, cholesterol, glucose, seromucoid, sialic acid, potassium, sodium, chlorine, calcium. Statistical, neural network and algorithms with elements of fuzzy neural networks were used on a sample consisting of hematological parameters of 274 patients with chronic kidney disease and healthy ones based on 25 laboratory parameters. Mathematical modeling was carried out at the Department of “Computer Technologies” of the Penza State University.Results. The effectiveness of neural network diagnostics of endogenous intoxication syndrome in patients with chronic kidney disease without chronic kidney failure reached 88.2%, and in patients with chronic kidney disease and chronic kidney failure – 97.6%.Conclusion. The neural network method of diagnosis can help improve the early diagnosis of endogenous intoxication syndrome in outpatient surgery.

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Lung Abscess and Gangrene: Evolution of Treatment Methods

Cited by 4 publications

References 5 publications

Angiopulmonography With Nitroglycerin Test in the Diagnosis of Acute Infectious Lung Destruction

Angiopulmonography With Nitroglycerin Test in the Diagnosis of Acute Infectious Lung Destruction

Clinical and radiological variants of lung damage in the infection caused by staphylococcus aureus

Outpatient diagnosis of endogenous intoxication in surgery

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