[Features of the diagnosis of tumors of the small intestine complicated by hemorrhage]. / Osobennosti diagnostiki opukholei tonkoi kishki, oslozhnennykh krovotecheniem.

Among 5,190 patients with gastrointestinal hemorrhage in 14 (0.27%) the bleeding was caused by tumor of the small intestine. The success of recognition of tumors of the small intestine complicated by bleeding is determined to a great measure by the sequence of the diagnostic procedures. It is most rational to begin the examination with endoscopy of the stomach and duodenum. In the absence of abnormalities in these organs rectosigmoidoscopy or colonoscopy is undertaken next. If the source of the bleeding is not detected in this case, then the small intestine is examined by means of probe radioenterography. During the operation, at the peak of bleeding, the authors search for its source along the "track" of blood by palpating the small intestine.

[Treatment of Mallory-Weiss syndrome by endoscopic diathermocoagulation]. / Lechenie sindroma Mallori-Veissa éndoskopicheskoi diatermokoaguliatsiei.

The work analyses the results of treatment of 111 patients with the Mallory-Weiss syndrome by endoscopic diathermocoagulation. It proved ineffective from the very beginning in 11 (9.9%) cases, in another 23 (20.7%) patients hemorrhage recurred in the immediate 4 days but in one third of them its source was another disease. The follow-up of 77 patients revealed recurrence of the disease in the late-term period (from 12 months to 9 years) after diathermocoagulation in 12 (15.6%), but only 2 of them had to be operated on. The operative mortality was 17%, but when surgery was combined with diathermocoagulation the mortality rate was 4.5%.

[The results of the endoscopic diathermy coagulation of hemorrhaging gastroduodenal ulcers]. / Rezul'taty éndoskopicheskoi diatermokoaguliatsii krovotochashchikh gastroduodenal'nykh iazv.

The authors analysed the results of endoscopic diathermy coagulation of bleeding acute gastroduodenal ulcers in 83 patients; in 47 of them the follow-up period ranged from 12 months to 9 years. A stable hemostatic effect was achieved in the early periods after coagulation of the acute ulcers in 76% of cases. The frequency of recurrent bleeding was found to be directly dependent on the degree of the blood loss. Recurrent bleeding from acute ulcerations of the gastric mucosa in the late-term period was discovered authentically in only one patient. It was linked with medication with brufen for a long duration. Thus, endoscopic diathermy coagulation produced good results in arresting bleeding from acute gastroduodenal ulcers, particularly in patients with a very high operative risk.

[Radioisotope diagnosis of localized inflammatory processes in the abdominal cavity]. / Radioizotopnaia diagnostika ogranichennykh vospalitel'nykh protsessov briushnoi polosti

The method of radioindication of localized inflammatory processes in the abdominal cavity was studies experimentally and clinically. Experimental studies were conducted on 48 animals with induced abscesses of different localization. The animals were injected RISA-J131 intravenously. A focus of inflammation has shown increased gamma-radiation that reached its maximum 24 hours following injection of the substance. A selective selective RISA-J131 accumulation in localized inflammatory foci was rather clearly seen on the obtained scannograms by means of an apparatus "Scinticard Numeric". Using this method 11 patients aged from 14 to 57 years were investigated: 4 males and 7 females. In neoplastic character of the disease scannograms have shown an even distribution of the isotope over the abdominal cavity. A selective accumulation of the substance in the region of an inflammatory focus was observed in inflammatory infiltrations. Radio-indication may be used as a valuable adjunct to topic and differential diagnosis of abscesses and inflammatory infiltrations of the abdominal cavity.

[Acute cholecystitis as a postoperative complication]. / Ostryi kholetsistit kak oslozhnenie v posleoperatsionnom periode.

The literature data on acute cholecystitis occuring as a complication after operations on the abdominal organs are analysed. The author presents 3 own observations of cholecystitis in early postoperative period among 28,556 laparotomies. Taking into consideration the rarity of this complication, the author believes that the arguments adduced for simultaneous preventive cholecystectomy in operations for other abdominal organs diseases are dubious, especially in emergent abdominal surgery.

[Various special problems of the treatment of acute peptic ulcer- induced gastrointestinal hemorrhage]. / Nekotorye chastnye voprosy lecheniia ostrykh iazvennykh zheludochno-kishechnykh krovotechenii.

The work has analyzed an experience with the treatment of 1336 patients with acute gastrointestinal bleedings of ulcerous etiology, 799 of them were operated upon. All the surgical interventions were divided into 3 categories: emergency operations (immediately after admission of the patient), delayed (within 24 hs) and planned operations (3 weeks later). Operative lethality was 5.2%, 11% and 1.8% correspondingly. Heavy blood loss was most frequent in gastric ulcer (37%) and retrobulbar ulcer of the duodenum (30%), less frequent in ulcer of the duodenum bulb (6.7%) and prepyloric ulcer (4.4%). Urgent fibrogastroscopy was used not only as a diagnostic method, but also as an attempt to control bleeding. Truncular vagotomy with draining operations are thought to be preferable for duodenal ulcers, for gastric ulcer--it is resection of the organ.

[Restoration of the continuity of the large intestine]. / Vosstanovlenie nepreryvnosti tolstoi kishki.

Restorative operations were performed on 55 patients aged from 15 to 76. In 35 patients the first operations were performed for carcinoma of the left half of the colon, in 20 patients -- for non-tumorous diseases. In 51 patients the first intervention was completed by the Hartman operation. In 4 patients a double anus was formed. Restorative operations were fulfilled within the period from 3 till 18 months. Complications in the postoperative period were noted in 21 patients. Five of them died: 4 patients -- from peritonitis and 1 -- from cardio-pulmonary insufficiency.

[The treatment of acute gastrointestinal hemorrhages at a specialized hospital]. / Lechenie ostrykh zheludochno-kishechnykh krovotechenii v spetsializirovannom statsionare.

A differential approach to surgical interventions corresponding to the system of treatment of patients with gastrointestinal bleedings developed by the authors gave considerably less lethality in patients with bleedings caused by acute gastric and duodenal ulcers and by the Mallory-Weiss syndrome. General lethality among these patients was 3.3% and 5.1% correspondingly. This system was most effective at large specialized centers for treatment of patients with acute gastrointestinal bleedings. However many of its principles are easy for a great number of practical surgeons.

[Surgical tactics in acute hemorrhage from the upper segments of the digestive tract]. / Khirurgicheskaia taktika pri ostrykh krovotecheniiakh iz verkhnikh otdelov pishchevaritel'nogo trakta.

Results of diagnosis and treatment of 1337 patients with esophageal and gastroduodenal hemorrhages were analyzed. The diagnostic and curative endoscopy is recommended. Variants of tactics of the operative and conservative treatment are proposed for the conditions of specialized hospitals of emergency medical service.

[Prevention and treatment of stress-induced ulcers]. / Profilaktika i lechenie stress-iazv.

The data presented show that along with acid-peptic aggression an important role in pathogenesis of stress ulceration in the stomach and duodenum belongs to energy and immune deficiency which makes the correction of these alterations necessary. The timely and valuable conservative therapy including histamine H2-receptor blocking agents in addition to antacids and endoscopic electrocoagulation in case of profuse bleeding from stress ulcers allows to obtain hemostasis and healing of the ulcers more than in 90% of cases. When choosing the surgical method of treatment the preference should be given to atraumatic organ-preserving operations.