[Foreign body-related acute ileus].
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Biomedical subjects
Publications and source records attributed to V B Akhrameev.
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The results of treatment of 182 patients with an acute ileus were analyzed. While roentgenography conduction the characteristical signs of the disease were noted in 68.7% of patients and in 31.3% they were absent or mildly pronounced. In the last situation a contrast substance passage was studied, permitting to make a diagnosis in 67.6% of patients.
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The clinico-roentgenological signs of acute commissural ileus were analysed in 226 patients. Of them, 192 were operated on. In 6.4% of the patients in plain roentgenography, the signs of acute ileus were absent, in 27.7%--they were not prominent. Study of the barium suspension passage through the small intestine, as the authors consider, is indicated in unmarked clinical features of the disease, and as well in its short duration (less than 6 h) with the aim of establishing a degree of ileus (complete, or partial).
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On the basis of the experimental investigation and clinical observations, the authors consider that the formation of inter-intestinal end-to-end anastomosis with two-layer interrupted suture of non-absorbable material creates the prerequisites for the development of suture failure and anastomotic stenosis. The removal of the mesothelium of the sutured intestinal surfaces leads to the early formation of adhesions between the organs. The first-turn placing of the internal layer of sutures with tightening the threads provides their timely eruption and rejection. The suturing of the mesenterial sites of the intestine with the surfaces covered by serous membrane increases the safety of anastomotic sutures and creates convenience for the work of a surgeon.
An observation of 184 patients treated for different intestinal fistulas allowed to conclude that the developed and introduced into clinic methods of hermetization of incomplete fistulas with the help of a porolon sponge and treatment of complete fistulas by special devices of original construction facilitates valuable preparation of patients to surgery and improves results of the surgical treatment of the disease.
The analysis of the results of treating 47 patients with complications of colonic diverticulosis was carried out. The diagnosis of the disease and its complications should be based on the strict consideration of the data of history, clinical manifestations with mandatory use of a roentgenologic method at the acute period. In perforation of diverticulum, the extraperitonization of a site of the colon is an operation of choice.
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