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Biomedical subjects

G Stoianov

Publications and source records attributed to G Stoianov.

At least 19 recordsLinked to original sources
PubMed2002

[Diagnostic puncture and puncture treatment of liver echinococcosis--"yes" or "no"].

The authors present as problematic and debatable the article about the diagnostic punction and punction treatment of the liver echinococcosis. Of many years scientific disputation about this problem exist. The risks of per cutaneum punction leads to many serious complications. This assess the revaluation of this method which must apply only in very limited evidence--small surface cysts without additional cysts and for diagnostic plan must be abandon.

Anaphylaxis↗
PubMed2002

[Acute surgical abdomen in idiopathic haemochromatosis].

The acute abdomen (AA) is a typical but very rare complication of idiopatic haemochromatosis (IH). The possible mechanisms are not sufficiently clarified. We report a case with IH who died with clinical features of (AA) 20 hours after gastroscopy was performed. The histological examination established nonspecific damage of visceral peritoneum and ascites. Fulminant form of spontaneous bacterial peritonitis (SBP) as a reason of death is discussed, nevertheless endoscopic esophageal varices sclerotherapy was not performed. The role of pulmonary infection and intestinal bacterial overgrowth with possible bacterial translocation in mesenterial lymph nodes, ascitic fluid, and blood is also discussed. The source of infection is usually unknown. The iron is important factor for bacterial growth. The pluriglandular deposition of iron including the suprarenal glands is precondition to development of collapse. The possible pathogenesis of SBP in IH is discussed. It is important to mention that unlike SBP the clinical course of IH AA might appear which does not necessary require surgical management.

Abdomen, Acute↗
PubMed2000

[Iatrogenic lesions of hepatocholedocus in cholecystectomy].

This is a report on nine patients presenting different intraoperative lesions to hepatocholedochus, some of them diagnosed in the course of operation, and others- after the intervention. A variety of plastic repairs of the hepatocholedochus, including simple suture, Saple's operation or hepatodigestive anastomosis after Longmayre are performed. The probability of inflicting lesions, the underlying causes and the therapeutic approach to concrete cases are analyzed. Abiding to the principles of surgery is strongly recommended, such as: sufficient and appropriate operative access, atraumatic manipulations, drainage of the gallbladder bed and the like, with a view to perclude serious and sometimes fatal complications' occurrence, as well as making early diagnosis and accordingly taking the most opportune surgical solution to the problem faced.

Bile Ducts, Extrahepatic↗
PubMed1999

[Francke's operation--a resolution for deep small echinococcal cysts of the liver].

The operation of Francke in hydatid disease treatment is described--puncture, aspiration, sterilization--with emphasis laid on the technical details. The indications for its practical implementation are specified--small echinococcus cysts, deeply located within the parenchyma of the organ, or diffuse abdominal echinococcosis. In diagnosing such cysts intraoperative ultrasonography is considered as absolutely necessary and mandatory. The operation is practicable in handling first-stage cysts according to Volynkin, containing thin echinococcus liquid only, whereas in the presence of daughter vesicles it is not indicated. Postoperatively, dispensary outpatient observation and chemotherapy of the hydatid disease are recommended with a view to promote radical cure.

Echinococcosis, Hepatic↗
PubMed1998

[Secondary sclerosing cholangitis after echinococcectomy].

This is case report concerning secondary caustic sclerosing cholangitis following scolecide with concentrated sodium chloride solution (30%) during operation on a liver echinococcus cyst with involvement of the extrahepatic biliary apparatus only. Hepatojejunostomy is performed. Histological study of the liver demonstrates evidence of severe cholangitis, purulent cholangiolitis and suspected secondary biliary cirrhosis. In conclusion, it is stressed that dynamic postoperative follow-up of patients is mandatory to make early diagnosis of the complication and undertake operative treatment anticipating the development of a cirrhotic process. The search for new, effective scolicides, not damaging the biliary apparatus and hepatic parenchyma, is strongly recommended.

Acute Disease↗
PubMed1997

[Perforations of hepatic hydatid cysts].

Out of a total of 753 patients operated for liver echinococcosis, in 43 (5.71 per cent) various perforations are observed, namely: in the biliary apparatus, chest, abdominal cavity, gastrointestinal tract, subphrenic and subcutaneous tissue. Their incidence in bile ducts is the highest. The lethality is rather elevated with two patients dying on the operating table. In conclusion, proceeding from the severity of the complication emphasis is laid on the necessity of early diagnosis of the disease, before development of serious complications, successfully achieved in the last few years.

Aged↗
PubMed1996

[Pre-, intra- and postoperative allergic manifestations in hepatic echinococcosis].

Data obtained from 502 patients operated for echinococcosis (hydatid disease) are analyzed. In 61 of them (12,15 per cent) a variety of allergic manifestations are observed before the operation. Serious allergic shocks intraoperatively, and lethal outcome due to allergic shock in the postoperative period are described. Inferences are reached about the necessity of performing mandatory examination of all allergic patients for echinococcosis as an eventual underlying cause of allergy, as well as mandatory preoperative tests for allergy to drugs and anesthetics along with undertaking antiallergic prophylaxis of patients in the postoperative period to obviate eventual allergic accidents, regardless of their presence or not in the previous history.

Adult↗
PubMed1996

[Percutaneous puncture in hepatic echinococcosis].

This is a report on a case of severe anaphylactic shock and hemorrhage following liver puncture with diagnostic purpose. Based on literature data and personal experience, percutaneous puncture of a parasitic expanding cyst, done with diagnostic and therapeutic purpose, is discarded, assuming the method as an error of art. Its performing using updated imaging techniques--echography and computerized tomography--by no means reduce the risk of anaphylactic shock and secondary echinococcosis. In the event of being accidentally done, emergency operation followed by chemotherapy to preclude secondary echinococcosis is recommended. In cases with unspecified diagnosis, puncture under echographic control is done on the operating table with urgent cytological assessment of the punctate. The demonstration of echinococcosis is an indication for immediate operation. The percutaneous method is used in handling nonparasitic cysts.

Adult↗
PubMed1995

[Intraoperative anaphylactic shock following the percutaneous puncture of a hepatic echinococcal cyst].

This is a report on a case of severe intraoperative anaphylactic shock, developing within several hours of percutaneous puncture of a liver hydatid cyst, performed under echographic control, necessitating recovery from the shock state and discontinuation of the operative intervention. Inferences are reached regarding the most adequate treatment tactics to be adopted in handling such cases. Percutaneous puncture is discarded as a therapeutic approach because of the great risk of anaphylaxis with eventual lethal outcome, and the likelihood of severe abdominal echinococcosis development at a later period.

Acute Disease↗
PubMed1994

[Nonparasitic liver abscesses].

Abscess of the liver is a comparatively rate, but very serious disease, necessitating the undertaking of diagnostic and therapeutic measures on an emergency basis. The principal diagnostic method currently in use includes two imaging techniques--echography and CT. In therapeutic respect the target puncture under echographic or CT control has rather limited scope of application. Surgical therapeutic approach is the leading one--laparotomy, drainage of the abscess, and arbitrary use of a Kerr drainage for the choledochus and regional antibiotic therapy.

Adult↗