[An algorithm for differential diagnosis searching in space-occupying lesions of the liver]. / Algoritm differentsial'no-diagnosticheskogo poiska pri ob''emnykh obrazovaniiakh pecheni.

The experience of examination of 584 patients with volumetric masses of the liver (VML) of various origin is presented. For successful differential diagnosis of VML and definition of rational surgical policy the algorithm of examination was considered with due regard for diagnostic stages, each of them being characterized by definite complex of tests. It is thought necessary to begin examination with noninvasive and highly informative tests. Complex of radioimmunologic evaluation of tumor markers level is advisable to include in diagnostic algorithm of patients with VML. The use of invasive methods of diagnostics is justified in complicated diagnostic situation. For evaluation of regional function of the liver radionuclear examination should be used. Liver puncture are feasible only whenever parasitic nature of cystic masses of the liver is excluded. If it is found to be impossible to determine the character of VML the question of advisability of diagnosis laparotomy should be resolved in its favour. The most efficient use of various methods of examination in 584 patients with VML of various genesis made it possible to increase accuracy of diagnosis of hepatic hemangioma, in nonparasitic cysts--1.7 times and in parasitic cysts--1.2 times.

[Diagnosis and therapeutic tactics in polycystic liver]. / Diagnostika i lechebnaia taktika pri polikistoze pecheni.

The results of clinical observations of 60 patients with polycystosis of the liver who had been treated or examined by the authors in the period from 1964 to 1989 were summarized. The clinical course of the disease was featured by scanty clinical signs: pains in the upper half of the belly and hepatomegaly were most frequent. The combination of diagnostic techniques for verification of surgical intervention necessity was established. Besides, it was stated that the diagnosis of polycystosis of the liver should be complex and based on anamnestic data and the results of clinical, laboratory and instrumental investigations. Preference should be given to ultrasonography and computed tomography. Cysts with diameter of 5 cm and more, complicated polycystosis of the liver (bleeding, suppuration, malignancy) and cystic compression of the extrahepatic bile ducts and vessels (portal and cava inferior veins) were found to be indicative signs for surgical treatment of hepatic polycystosis. A total of 41 patients were subjected to surgical treatment with 49 operational procedures employed. Fenestration of hepatic cysts (42), that were organosparing operations, predominated. Resection of the liver was performed in 2 patients who had total cyst substitution for the whole of the left lobe. The improvement registered in 85.7% of operated on patients evidenced the favorable results of surgical treatment.

[Laboratory and instrumental diagnosis of echinococcosis during conducting mass screening and surgical treatment]. / Laboratornaia i instrumental'naia diagnostika ékhinokokkoza pri provedenii dispanserizatsii i khirurgicheskom lechenii.

In the course of 15 years the authors conducted a comprehensive examination of over 13,000 patients for establishing the diagnosis and surgical treatment of hydatid disease; among these patients there were more than 3,000 who underwent operation, 1,280 who were examined for recurrence of the disease, and 5,000 who were subjected to periodical medical examination. The enzyme immunoassay and indirect hemagglutination test are the most reliable in the diagnosis of primary and recurrent hydatid disease and in periodical examination; the latex fixation test remains false-positive (16.9%) up to 3 years. Combination of laboratory and instrumental methods (computed tomography, ultrasonic examination, scanning and multi-view X-ray examination) makes it possible to establish not only the topical diagnosis but also the state of the hydatids, which helps in the choice of the operative method.

[Computer tomography, echography and thermography in the diagnosis of extrarenal complications in a transplant]. / Kom'piuternaia tomografiia, ékhografiia i termografiia v diagnostike ékstrarenal'nykh oslozhnenii transplanta.

Computed tomography, echography and thermography were used for detection of extrarenal complications in 22 patients at different time after kidney transplantation. Morbid perirenal formations were found in 12 patients (hematoma in 4 patients, abscess--in 2, lymphocele--in 5, urinoma in 1). The complex of these methods allows to detect and establish the character of the peritransplant fluid collections.