[A giant pseudotumor of the pancreas].
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Biomedical subjects
Publications and source records attributed to R A Zhenchevskiĭ.
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Experiments in animals have shown that the pathoimmune component or sensibilization of organism followed by the inflow of the challenge factor into the abdominal cavity plays an important role in pathogenesis of chronic peritonitis with a productive reaction (adhesive process, fibrose capsule, pseudotumors).
149 patients were operated upon for the adhesive process in the abdominal cavity. The antirecidivation treatment was performed after operation (intraperitoneal injection of prolonged proteolytic enzymes with hydrocortisone, trypsin electrophoresis). The enzyme therapy was associated with the antiinflammatory and antiallergic treatment. Long-term results were studied in 93 patients within the period from 2 to 10 years. Good results were obtained in 77% of the patients.
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The article presents the analysis of the role of chronic omentites and adhesions of the greater omentun in the course of the "adhesive disease". The omental adhesions were revealed in 70,5% of the operated patients. In 20 of 105 patients chronic omentitis was found and 4 patients had acute omentitis. Under conditions of adhesions and omentitis the greater omentum is believed to turn from the organ of immune defense in the the cause of the appearance of different clinical symptomocomplexes. So, the author considers that in omentitis the resection of the greater omentitis is indicated and patients with its adhesions have indications for the replacement of the omentum and its fixation in the epigastric region, before the stomach.
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According to the author's findings both during the operation for postoperative hernias and abdominal adhesions and postoperatively the use of proteolytic enzymes, antiallergic therapy, and stimulation of the bowel peristalsis would give favourable results with a complete recovery of patients, in whom besides hernia also abdominal adhesions were observed. The operative technic is described.
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