[X-ray-surgery of diverticular disease complicated by abscess formation].

Autor:	Okhotnikov OI; Department of X-ray surgical diagnosis and treatment #2 of Kursk Regional Clinical Hospital, Kursk, Russia., Yakovleva MV; Department of X-ray surgical diagnosis and treatment #2 of Kursk Regional Clinical Hospital, Kursk, Russia; Chair of Surgical Diseases of Kursk State Medical University, Healthcare Ministry of the Russian Federation, Kursk, Russia., Shevchenko NI; Department of X-ray surgical diagnosis and treatment #2 of Kursk Regional Clinical Hospital, Kursk, Russia., Grigoriyev SN; Department of X-ray surgical diagnosis and treatment #2 of Kursk Regional Clinical Hospital, Kursk, Russia., Pakhomov VI; Department of X-ray surgical diagnosis and treatment #2 of Kursk Regional Clinical Hospital, Kursk, Russia.
Jazyk:	ruština
Zdroj:	Khirurgiia [Khirurgiia (Mosk)] 2018 (6), pp. 35-40.
DOI:	10.17116/hirurgia2018635-40
Abstrakt:	Purpose: Show the possibility of an alternative use of interventional radiology techniques in complex treatment of patients with inflammatory complications of the diverticular disease of the colon. Material and Methods: In 2012-2016, there were 87 patients under our supervision with complicated diverticular disease. In 57 (65.5%) cases were diagnosed infiltrate, in 24 (27.6%) cases - abscess of paracolon area (Ib-II type by Hinchey), in 6 (6.9%) cases (III-IV type according Hinchey) generalized peritonitis have been identified. Results: Emergency laparotomy was performed in 13 patients. Abscesses of paracolon (Ib-II type by Hinchey) area were diagnosed sonographically during the initial examination in 17 patients. 26 percutaneous drainage of diverticulogenous abscesses of different localizations self-locking drainage #8Fr 'pig tail' was carried out under the combined ultrasonic and X-ray control in this group of patients. The technical success of percutaneous drainaging of the abscesses was achieved in all manipulations. 13 patients had a single drainaging, and for diverticular disease - disease-free during the observation period of 1 year to 5 years. Resection of the colon in a planned manner after percutaneous drainage of recurrent abscess of paracolon area was performed in 4 patients. Complications related with the technique of installing drainage were not reported, mortality in the group of drained patients was absent. Conclusion: Ultrasound examination of patients with suspected inflammatory complications of diverticular disease - a necessary and sufficient method for initial diagnosis of the disease. Percutaneous drainage of diverticulogenous abscesses (Hinchey Ib-II) is represented by the pragmatic 'first line' choice in patients with complicated diverticular disease, that allows to treat the pathology steadfastly in most of the cases.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu