Morphological changes in the wall of the large intestine were studied after its manual suturing by a double-row interrupted suture with modern suture threads. Light and scanning electron microscopy showed "fuse properties" and "sawing effect" of polyfilament twisted threads (e.g. vicryl). Monofilament threads were free from these drawbacks and therefore were preferable. Metal elastic threads on the basis of titanium-nickelide alloys caused no inflammatory changes in tissues.
The article describes clinical case of a patient with two rectovaginal fistulas of high and low level. The first stage included diverting loop sigmostomia and latex seton for low fistula. Three months later, on the second stage, fistulectomy with invagination of the fistula to rectal lumen with compression of invaginated part by titanium nickelide clamp was done. The fistulectomy with sphincteroplasty was done for the lower fistula. No postoperative complications developed; the complete recovery was detected. Seven months later, on the third stage, the stoma closure was done. No complications and fistula recurrence were obtained in 2 months of follow-up.
Objective: to analyze the diagnostic value of radiation techniques in patients with opisthorchiasis-induced obstructive jaundice and to determine the types of bile duct (BD) changes characteristic of this disease.Subjects and methods. The investigation enrolled 103 patients with chronic opisthorchiasis complicated by obstructive jaundice. For BD visualization, the investigators used radiation diagnostic methods, such as ultrasonography (USG), magnetic resonance cholangiopancreatography (MRCP), and endoscopic retrograde cholangiopancreatography (ERCP); their efficiency was evaluated.Results. ERCP and MRCP could identify 5 types of BD architectonics in opisthorchiasis-induced obstructive jaundice. The sensitivity, specificity, and overall accuracy of MRCP in diagnosing opisthorchiasis-induced sclerotic changes were 98.1, 87.5, and 96.8%, respectively.Conclusion. Among instrumental methods for diagnosing sclerotic BD changes in prolonged opisthorchiasis invasion, it is preferable to use MRCP, which is determined by its high informative value. Five types of cholangioarchitectonics are detectable in chronic opisthorchiasis complicated by obstructive jaundice.
In modern abdominal surgery purulent septic complications are the main reason of lethality in postoperative period. At the same time the problem of surgical suture reliability of large intestine remains very actual. Different methods of study of anastomosis physical containment (such as pneumo-, hydro-pressure, study of intestinal wall rupture force) are used for evaluation of the quality of formed anastomoses. In literary review there is a comparative description of different methods of anastomosis mechanical solidity determination; the self-descriptiveness of these methods, their advantages and disadvantages are analyzed; questions of study of large intestine anastomosis elasticity are discussed.
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