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Biomedical subjects

R A Nikhinson

Publications and source records attributed to R A Nikhinson.

11 recordsLinked to original sources
PubMed1991

[Clinical characteristics of acute cholecystitis in males].

The analysis of 682 case histories of males suffering from acute cholecystitis suggested a conclusion on occasional deviations in clinical manifestations of the disease in males. Various combinations of complications are not a rare finding making the diagnosis problematic. Acute destructive process in the gall bladder occurs in the presence of chronic inflammatory and infiltrative alterations in the hepatopancreatoduodenal area. Clinically, general symptoms of endotoxicosis dominate, local signs presenting indistinctly. Late diagnosis results in late surgical treatment: 9.2% of the admitted patients only are operated on within 24 hours since hospitalization. The authors hold that choledochotomy is indicated to 50.7% of the patients. Lethal postoperative outcome was registered in 2.2% of those operated on. The deaths were attributed to cardiovascular and hepatic failure.

Acute Disease↗
PubMed1991

[Acute cholecystitis in the early postoperative period].

The authors observed 6 patients, who developed acute cholecystitis at day 2--5 after the operation. In 3 patients, an operation on the abdominal organs was performed, in 3--the urologic intervention. The leading symptoms of postoperative cholecystitis are the following: epigastric pain, stable intestinal paresis, high body temperature. The authors recommend a wide use of the ultrasound investigation of the abdominal cavity, and in its negative results, or in absence of the apparatus--laparoscopy. All the patients were reoperated. One patient died.

Acute Disease↗
PubMed1990

[Repeat surgery in focal lesions of the liver].

The authors had 302 patients with focal lesions of the liver, 232 of them were operated on. Radical operations were carried out on 96 and palliative operations on 136 patients. Operations were performed for a second time in 35 patients, radically in 24 of them. A previously conducted exploratory laparotomy is still no evidence of inoperability of the process. In alveococcosis of the liver with no clinical signs of biliary stasis, it is advisable to consider resection of the liver after a previously conducted bile-draining operation. Patients who had been subjected to cavernotomy may also be operated on radically. The appearance of jaundice in the late-term periods after resection-fragmentation of the liver indicates growth of the remaining area of the parasitic nodus and dictates the indications for a bile-draining operation. Obstructive jaundice is considered the main indication for undertaking a palliative operation for the second time. Five patients died after surgery.

Adolescent↗
PubMed1990

[Diagnosis and surgical treatment of cancer of the gallbladder and extrahepatic bile ducts].

Data on 148 cases of cancer of the gallbladder and extrahepatic bile ducts were studied. Jaundice proved the cardinal symptom. No clear-cut clinical picture of the disease was identified. Diagnostic procedure should start with ultrasonography. Cholangiectasia and the enlarged pancreatic head make the case for fiber bronchoscopy and hypotonic duodenography. Cancer-negative patients should further undergo transcutaneous transhepatic cholangiography and, if proving still negative, retrograde cholangiopancreatography. Resection of bile ducts with simultaneous lymphadenectomy is considered radical. The authors suggest a surgical procedure for cancer of the gallbladder which includes resection of the liver, hepatico-choledoctomy and cholecystectomy with formation of cholangio-jejuno-anastomosis using disposable transhepatic drains. Recanalization of bile ducts by transhepatic drain is considered optimal for palliation. Survival depends upon extent of surgery and level of bile duct obstruction.

Adenocarcinoma↗
PubMed1989

[Questions of tactics and choice of surgery in gastroduodenal hemorrhage].

The authors analysed 368 clinical cases with gastroduodenal hemorrhages. The changes in blood microcirculation and nonspecific immunity were studied in 62 patients. They proposed a method of complex nonoperative treatment of gastrointestinal hemorrhages, including ganglionic block, which made it possible not only to reduce the operative activity but also to achieve epithelialization of ulcers in patients with peptic ulcer. As the result of the study, a unique classification of the severity of blood loss is suggested which is based on the degree of deviation off the tests studied from the normal values. If gastroduodenal hemorrhage continues, an operation is recommended, the character of which is determined by the patient's age, the severity of blood loss, and the source of bleeding and its localization.

Duodenal Ulcer↗
PubMedDate not supplied

[Liver resection in closed injuries].

The authors have observed 129 patients with closed injuries of the liver. Resection is thought by the authors to be indicated to patients with vast wounds when there are areas with disturbed blood circulation, in patients with abruptions and crush of portions of the liver. Operations on most patients were performed as atypical resections with transparenchymatous ligation of the vessels and bile ducts. Lethality did not depend on the resection volume but was in direct correlation with the character of associated injuries. After resection of the liver 13 patients of 31 died. Of 98 patients who had ruptures of the liver and were subjected to other operations 47 patients died.

Adolescent↗