[Diagnosis and treatment of post-traumatic coagulated hemothorax]. / Diagnostika i lechenie posttravmaticheskogo svernuvshegosia gemotoraksa.

Analysis of 102 cases of coagulated hemothorax (CH) are presented: 32--after penetrating wounds and 70--after closed chest injury. In 57% patients with chest wounds and 72% patients with closed injury the cause of CH was to applying late for medical care. Diagnostic value of X-ray, ultrasonic methods, CT and pleural puncture was studied. Depending on the patients state severity, CH volume and stage of it formation conservative treatment, streptase administration, thoracoscopy and thoracotomy with pleurectomy and lung decortication were performed. Lethality was 2.9%.

[X-ray study in the diagnosis of traumatic mediastinitis and its complications]. / Rentgenologicheskoe issledovanie pri diagnostike travmaticheskogo mediastinita i ego oslozhnenii.

The study was based on the clinical and X-ray analysis of 68 patients treated at the Thoracoabdominal Surgery, N.V. Sklifosovsky Research Institute of Emergency Care, in 1992-1997. The paper gives pre- and postoperative X-ray findings of patients with mediastinitis. It shows it possible to define the precise location of a mediastinal inflammatory process, its severity and possible complications. The X-ray symptomatology of mediastinitis is presented according to the location and developmental stage of a mediastinal process. Jointly with surgeons, the authors have developed a procedure for X-ray examination of patients in the postoperative period, which involves the study of the course of the disease and the evaluation of the adequacy of performed treatment. The paper analyzes the most specific and severe complications of traumatic mediastinitis. Special emphasis is laid on the fact that during control X-ray studies it is important to keep the procedure that permits timely diagnosis of complications at different developmental stages of mediastinitis.

[X-ray diagnosis features of acute bleeding ulcers of the stomach and duodenum]. / Osobennosti rentgenodiagnostiki ostro krovotochashchikh iazv zheludka i dvenadtsatisperstnoi kishki.

The paper is based on the analysis of clinical, X-ray, and morphological studies in 74 patients with massive gastrointestinal hemorrhage who were treated at the hospitals of the N.V. Sklifosofsky Research Institute of Emergency Care, in 1991-1994. Among the examinees, there were 28 with medio-gastric ulcer and 44 with parapyloric ulcers. In 2 patients bleeding occurred with the anastomosis ulcers of the stomach operated on. The paper presents the specific features of X-ray studies of patients with bleeding gastroduodenal ulcers. X-ray studies should be twice performed in these patients. The first study is conducted if gastroscopic findings are unclear, the repeated one is carried out while assessing changes in disease regression. The emergency gastroscopic and subsequent X-ray studies have demonstrated that acute ulcers may be at various sites and multiple. X-ray diagnosis of bleeding ulcers is determined by their sites and the nature of an ulcerous process. The X-ray diagnosis of chronic callous gastric ulcers accompanied by hemorrhage was based on the detection of two direct symptoms of a "niche" on the gastric outlines and configuration and an inflammatory mound on the gastric outline and configuration. That of chronic bleeding ulcers of the duodenal bulb is based not only on searches for the basic symptom of peptic ulcer -"niche", but other signs of the disease-the deformed organ, and the magnitude of a periprocess. Gastroduodenoscopy is applied not only for the primary diagnosis of a hemorrhagic source, but a therapeutical technique. However, the use of endoscopy alone in patients with gastroduodenal hemorrhage did not give a comprehensive idea of the magnitude of ulcerous changes, organ-specific deformity, and a periprocess.

[Errors and difficulties in emergency x-ray diagnosis of traumatic ruptures of the diaphragm]. / Oshibki i trudnosti neotlozhnoi rentgenodiagnostiki travmaticheskikh razryvov diafragmy.

A clinical and x-ray analysis of 30 cases with closed ruptures of the diaphragm and concomitant injuries is presented. Some aspects in the methodology of x-ray examination of patients with grave combined injuries are discussed and the importance of early contrast examination of the gastrointestinal tract emphasized. The author analyzes the difficulties associated with and errors occurring in x-ray examination. Some errors may be due to inappropriate timing of x-ray contrast examination. Rupture of the diaphragm may have no clear-cut x-ray signs in the first hours of the injury because of hemothorax, but a dynamic x-ray monitoring helps timely diagnose it.

[X-ray characteristics of acute intestinal obstruction in middle-aged and elderly patients]. / Rentgenologicheskie osobennosti ostroi kishechnoi neprokhodimosti u lits pozhilogo i starcheskogo vozrasta.

The authors presented clinical and x-ray findings of 188 patients with mechanical intestinal obstruction (92 of them were middle-aged and advanced in years and 96 were under 60). A combined program of x-ray examination included 3 stages: panoramic polypositional roentgenography of the chest and abdominal cavity, dynamic x-ray control over the state of the abdominal cavity, and contrast study of the G.I. tract. A distinctive feature of the x-ray symptomatology of intestinal obstruction in middle-aged and old patients was the absence of classical x-ray symptoms in some cases during panoramic roentgenography of the abdominal cavity. In patients over 60, x-ray symptomatology was characterized by marked colon distension and intestinal distension of various degree in 77.1%

[Late complication of angiography - thorotrastoma causing pharyngeal phlegmon]. / Pozdnee oslozhnenie angiografii - torotrastoma, vyzvavshaia flegmonu glotki.

Carotid angiography with the use of thorium dioxide for brain tumour diagnosis has been performed in a woman 35 years ago. In the course of angiography thorium dioxide penetrated into the paravascular space with subsequent development of "thorothrustoma" the clinical symptoms of which progressed for years (compression of neck organs and nerves, gradual disturbance of swallowing). As a result of compression a decubitus ulcer and phlegmona of the pharyngeal wall developed. Late diagnosis of the phlegmona and its inadequate treatment resulted in aspiration pneumonia which was a direct cause of the patients death.

[Use of contrast radiography in acute obstruction of the small intestine]. / Primenenie kontrastnogo metoda issledovaniia pri ostroi tonkokishechnoi neprokhodimosti.

The authors believe that the contrast radiography of the small intestine in case of its obstruction should be used on strict indications only and only in patients with unclear clinical and roentgenological picture. When following the method strictly, the examination is safe for the patient, it may be stopped at any stage when evident symptoms, both clinical and roentgenological, of the obstruction appear.