[Phlegmon of retroperitoneal cellular tissue after endoscopic papillosphincterotomy]. / Flegmona zabriushinnoi kletchatki posle éndoskopicheskoi papillosfinkterotomii.

Phlegmon of retroperitoneal cellular tissue as a complication of endoscopic papillosphincterotomy (PST) was observed in 9 patients. All these patients in the first several hours after PST complained of pains in epigastrium and right hypochondrium. 2 days later the signs of pyogenous intoxication appeared. For diagnosis of complications after PST roentgenological and radionuclide methods as well as US examination and computer tomography were used. For exploration of retroperitoneal phlegmon extraperitoneal approach was employed. The phlegmon cavity was drained by number of tubes TMMK and aspiration-lavage treatment 3 patients died.

[The surgical treatment of retroperitoneal phlegmons]. / Khirurgicheskoe lechenie zabriushinnykh flegmon.

Based on the experience with treatment of 112 patients with retroperitoneal phlegmons of different etiology the authors distinguish and describe the diffuse and complicated forms of the disease. In treatment of phlegmons special importance is attached to the optimal surgical access. The article describes main principles of performing sanitation of the suppurative foci of the retroperitoneal space, variants of the aspiration-irrigation methods of treatment of the suppurative process. The authors believe that their original differentiated surgical method using different variants of the aspiration-irrigation drainage is effective in treatment of patients with retroperitoneal phlegmons. This method of treatment gave 23.2% lethality while after the traditional methods of treatment 90% of the patients died.

[Microbiological diagnosis and antibacterial therapy of non spore-forming anaerobic infections in emergencies]. / Mikrobiologicheskaia diagnostika i antibakterial'naia terapiia nesporoobrazuiushchikh anaérobnykh infektsii pri neotlozhnykh sostoianiiakh.

A total of 240 patients with soft tissue and wound suppurations, peritonitis, and suspected sepsis were examined. Anaerobic isolates were more frequently obtained in 20-75% of patients infections associated with facultative microbes. The use of non-culture media (bacterioscopy and gas-liquid chromatography) increased the detection rate of anaerobic infection up to 82% as compared with bacteriological diagnosis (63%). The findings and the data of monitoring of suppuration agents for several years allowed the authors to work out effective combined treatment regimes for early mixed aerobic and anaerobic infections in 80-100% of patients.

[Aspiration-lavage treatment in suture incompetence of the duodenal anastomoses and stump following gastric resection]. / Aspiratsionno-promyvnoe lechenie pri nesostoiatel'nosti shvov anastomozov i kul'ti dvenadtsatiperstnoi kishki posle rezektsii zheludka.

An analysis of results of 26 patients has been made who had incompetent sutures of anastomoses and stump of the duodenum at the nearest postoperative period after gastric resection. In 14 patients (main group) aspiration-lavage method of drainage was used, in 12 patients (control group) other methods of treatment of incompetent sutures were employed. The advantage of the aspiration-lavage method of treatment over other methods is shown.

[X-ray diagnosis of a phlegmon of the retroperitoneal space tissue]. / Rentgenologicheskaia diagnostika flegmony kletchatki zabriushinnogo prostranstva.

The paper is concerned with the results of a combined x-ray study of 36 patients with phlegmon of retroperitoneal fat (RF). The x-ray procedure was described, potentialities and effectiveness of each method (panoramic polypositional investigation of the chest and peritoneal cavity, a contrast study of the G.I. tract) were shown. X-ray semeiotics of phlegmon of RF of different sites, the main differential and diagnostic signs to distinguish between phlegmon and accumulation of gases of other sites and its causes, were described in detail. The accuracy of phlegmon detection with these methods was 97.2%; phlegmon was detected in 35 of 36 patients.

[The dynamics of the wound microflora in the victims of the earthquake in Armenia]. / Dinamika mikroflory ran postradavshikh pri zemletriasenii v Armenii.

The data on the composition of wound microflora, as well as changes in the contamination index over the course of treatment of patients with the syndrome of prolonged compression, who were brought to the institute after the earthquake in Armenia, are presented. The authors characterize the structure of the causative agents of wound infection in the patients treated at the traumatological department of the institute over several years. The epidemiological situation in the hospital in the period when the earthquake victims were treated there is analyzed.

[Continuous aspiration in prevention of postoperative wound suppuration]. / Postoiannaia aspiratsiia v profilaktike nagnoeniia posleoperatsionnoi rany.

The aspiration method of preventing suppurations (after Redon) was used in 948 patients. After "pure" operations suppurations were found to appear in 0,8%, after "conventionally pure" operations in 1,3% and after operations associated with a considerable postoperative risk of a wound infection--in 17% of cases. The aspiration--irrigation method of preventing suppurations was used in 69 patients operated under conditions of a developing purulent process. Suppuration of the wounds was found to develop in 1,3% of cases.

[Relapsing parasitic embolism of the pulmonary artery in hepatic echinococcosis]. / Retsidiviruiushchaia parazitarnaia émboliia legochnoi arterii pri ékhinokokkoze pecheni.

A case of multiple echinococcosis of the liver in a woman of 52 complicated by perforation of the parasite cyst into the right hepatic vein, repeated parasitic embolism of the pulmonary artery and anaphylactic shock is presented. A set of changes in the lungs in this process is described: giant-cell arteritis and thromboarteritis, hemorrhagic infarctions, giant-cell reaction in the reticular definite tissue as well as sarcoid reaction in bronchopulmonary and tracheo-bronchial lymph nodes.

[Sensitivity of the causative agents of suppurative-inflammatory diseases to medical bacteriophages]. / Chuvstvitel'nost' vozbuditelei gnoino-vospalitel'nykh zabolevanii k lechebnym bakteriofagam.

Sensitivity to therapeutic bacteriophages and antibiotics of 2063 cultures causing purulent inflammatory diseases was studied. Sensitivity of Staph. aureus to therapeutic bacteriophages was higher (88.5%) than that to benzylpenicillin (33.7%), ampicillin (64.3%), erythromycin (53.7%) and close to that to aminoglycosides, tetracycline, lincomycin and chloramphenicol. The number of Ps. aeruginosa strains sensitive to the phages amounted to 67.1%. E. coli and Proteus were sensitive to therapeutic bacteriophages in 32.4 and 29% of the cultures respectively. All of the streptococcal strains isolated from the patients were resistant to phages. A favourable clinical effect of phages was observed in 37 out of 80 patients. The results of the study showed the advisability of the wide use of bacteriophages in combined treatment of purulent inflammatory diseases.

[The infectivity of surgical wounds]. / Infitsirovannost' khirurgicheskikh ran

A study was made of microbial contamination of wounds and wound fluid in 114 patients operated upon (clean and conditionally clean operations). Directly before suturing the subcutaneous-fatty cellular tissue no microbes were revealed in 50% of cases, but in 23% of cases potentially pathogenetic microorganisms were isolated. Potential causative agents of purulent infection were revealed in 50% of the patients on the 1st-3rd postoperative days. Suppuration developed in 3 cases only. In a number of cases there were revealed in the wound discharge such microbes which were not detected before the wound was sutured. Sometimes the presence of even numerous potentially-pathogenic microbes in the wound secretion led to no suppuration.