[An unusual complication of lymphatic paronychia].
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Biomedical subjects
Publications and source records attributed to G I Dikhtenko.
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The results of treatment of 39 patients with complications caused by presence of foreign bodies in the stomach and intestine are presented. Conservative treatment was performed in detection of a single foreign body with a length up to 10 cm. The foreign body staying at the same place for three days should serve an indication for operation. The emergency operation should be performed in presence of multiple foreign bodies in the stomach, when their length is more than 10 cm. and in development of complications--perforation of a hollow organ, development of hemorrhage, abscess, or infiltrate in the abdominal cavity.
For 10 years, 26 patients underwent treatment for complications caused by presence in the stomach and intestine of the foreign bodies with low radio-opacity and echogenicity. All the patients were operated on. At operation, a cause of the disease was established: in 17 cases--a fish bone, in 5--a small chicken bone, in 1--a conifer needle, in 2--a wooden chip, in 1--a home-made toothpick.
In a period of 5 years 790 patients underwent operation in the surgical clinic for cholelithiasis. Relaparotomy had to be conducted on 23 (2.9%) patients because intraabdominal complications occurred: escape of bile from the gallbladder bed and choledochus in its drainage, and development of peritonitis in 13 patients, pancreatitis in 2 patients, abdominal abscesses in 5, bleeding into the free abdominal cavity and the gastrointestinal tract in 3 patients. The diagnosis of complications is difficult. The developing symptoms are masked by infusion and antibiotic therapy, injection of narcotics, intestinal paresis. A complex approach is conducive to the establishment of the diagnosis: one doctor in charge, intensive surveillance of the patient, study of the results of laboratory and clinical methods of examination in dynamics. The indications for operation should be considered from the very onset in some cases. Nine (39.1%) patients died after relaparotomy.
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