Multistage treatment of a patient with spontaneous rupture of the esophagus in a multidisciplinary hospital setting

Демко, А.Е.; E, Andrei; Sinenchenko, G. I.; Георгий, И Синенченко; Kulagin, V I; Владимир, И Кулагин; Ivanov, V.I.; Владимир, И Иванов; Бабич, А. И.; Александр, И Бабич

doi:10.17816/mechnikov201911393-95

Cited by 4 publications

(1 citation statement)

References 4 publications

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“…Некоторые авторы для определения лечебной тактики пользуются Питсбургской системой оценки тяжести перфорации пищевода [10]. При отсроченном поступлении больных, когда диагноз установлен несвоевременно, первоначальное лечение должно быть направлено на устранение сепсиса, эндогенной интоксикации, проведение антибиотикотерапии, дренирование плевральной полости и средостения, восстановление трофического статуса.…”

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Endoscopic techniques and their effectiveness in the treatment of the boerhaave´s syndrome (clinical observation)

Зубарев

Николаевич²,

Дзидзава

et al. 2020

Russian Military Medical Academy Reports

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Minimally invasive endoscopic methods are gradually being introduced in all areas of medicine. Esophageal surgery is no exception. Recently, endoscopic clipping of the mucous membrane for fresh ruptures, stenting of the esophagus and Vacuum Assisted Closure have been used in the treatment of injuries of the esophagus when radical surgery is impossible and purulent complications develop. As the techniques were mastered, they were introduced into the clinic. This article presents a clinical observation of the treatment of a 56-year-old patient with a spontaneous rupture of the esophagus (Boerhaave΄s syndrome), who at certain stages of treatment used certain endoscopic techniques that allowed to stabilize the patient in the early stages of treatment and preserve the esophagus and its functionality in the future. The duration of the patient΄s treatment in the clinic was 45 days. Subsequent follow-up examinations did not reveal any abnormalities in the patient΄s health that required surgical correction. This observation allowed us to look at the problem of treating this group of patients from a different angle and form new algorithms for treating patients using minimally invasive methods (6 figs, bibliography: 10 refs).

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Section: заключениеunclassified

Endoscopic techniques and their effectiveness in the treatment of the boerhaave´s syndrome (clinical observation)

Зубарев

Николаевич²,

Дзидзава

et al. 2020

Russian Military Medical Academy Reports

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Treatment of a 5-year-old child with damage to the esophagus: a case report

Белов

Cyleva²,

Grigoryuk³

2021

Russian Journal of Pediatric Surgery, Anesthesia and Intensive

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Diagnosis and treatment of esophageal injuries remain the most difficult problems in pediatric urgent surgery with high mortality rates. Restoration of function in severe multiple-organ disorders associated with the development of mediastinitis and sepsis in children requires a multidisciplinary approach and the search for alternative treatment methods that help close the esophageal defect and prevent inflammation. These methods include a constant negative pressure system. Severe polytrauma led to the development of local inflammation and mediastinitis. The formed esophageal fistula with clinical sepsis required multistage surgical treatment and support of several specialists. At the Regional Childrens Clinical Hospital No. 1 in Vladivostok, at the first stage of treatment, the mediastinum and soft tissues of the neck were drained, which made it possible to stop the spread of inflammation and stabilize the patients condition. The effectiveness of the second stage of surgical treatment using the VAС system was noted in the first 48 h, in the form of a significant reduction in local inflammation and elimination of skin maceration. The VAС system provided adequate drainage of the wound cavity and promoted wound cleansing and growth of granulation tissue. Dissociation of the fistula by applying a gastrostomy made it possible to create favorable conditions for the healing of the esophageal defect and ensure adequate enteral nutrition for the patient. Damage to the esophagus with the development of mediastinitis and sepsis are critical conditions; therefore, treatment outcomes depend on early diagnosis and timely surgical treatment. A full-fledged surgical treatment in a specialized hospital helps eliminate complications of damage to effectively restore functions and lead to patient recovery.

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Surgical Tactics in Patients With Spontaneous Esophagus Rupture

Бабич¹

2020

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Multistage treatment of a patient with spontaneous rupture of the esophagus in a multidisciplinary hospital setting

Cited by 4 publications

References 4 publications

Endoscopic techniques and their effectiveness in the treatment of the boerhaave´s syndrome (clinical observation)

Endoscopic techniques and their effectiveness in the treatment of the boerhaave´s syndrome (clinical observation)

Treatment of a 5-year-old child with damage to the esophagus: a case report

Surgical Tactics in Patients With Spontaneous Esophagus Rupture

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