DEPENDENCE OF THE TREATMENT TACTICS OF THE PATIENTS WITH ACUTE COLONIC OBSTRUCTION ON THE ULTRASOUND RESEARCH RESULTS
About the author:
Tamm Т. I., Nepomnyaschy V. V., Barduck A. Ya.
Heading:
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
Scentific article
Annotation:
The treatment results of the patients with ACO are unsatisfactory because of both high figures of post-operative complications (40-60%) and post-operative mortality up to 30-60%. Surgeons have not yet reaches consensus about treatment tactics of the patients with obstructive ileus because of their serious condition. The aim of the work is to set objective criteria among patients with ACO which determine the choice of the terms and volume of operative intrusion. Results. The results of the treatment of 168 patients with acute colonic obstruction having been in the hospital from 2014 to 2019 are presented in the work. There were 76 (45,2%) men, 92 (54,8%) women at the age from 37 to 85 years old. The patients over 60 were more than 65%. In 4-5 days from the beginning of the disease 85% of the patients were hospitalized with sub-compensated and decompensated clinical picture of acute colonic obstruction. The diagnosis of the disease was defined on the basis of anamnesis data, objective examination, clinic-biochemical marks, radiation research methods (USR and abdominal x-ray), rectoscopy and colonoscopy. Advantage of USR was demonstrated in sub-compensated and decompensated colonic obstruction diagnostics. The diagnostics and treatment tactics of the disease was based on USR data. The conservative therapy among patients with ACO was stated to be carried out in the absence of peritonitis signs and positive dynamics of local changes in the colon according to USR data, urgent operative intrusions in patients with ACO were carried out in presence of free fluid in the abdominal cavity and negative dynamics of ultrasound criteria from outside the intestine, degree of impaired bowel contractility determined with the help of USR is the criteria of the choice of intestine decompression method. Post-operative mortality was 11,9%. Ultrasound research method is not invasive, available and highly informative in diagnostics of colonic obstruction of tumor genesis.
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