[Ultrasonic differential diagnosis of small echo-positive formations in kidneys].
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Biomedical subjects
Publications and source records attributed to V G Nikitin.
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A total of 437 patients with chronic pancreatitis (CP) were examined. The authors detected interstitial or acute, parenchymal or recurrent, hyperplastic or pseudotumorous, and cystic variants in 91 (20.8%), 218 (49.9%), 78 (17.8%), 22 (5.1%), and 28 (6.4%) patients, respectively, Severe types due to the permanent pain syndrome, substantial weight loss and overall intoxication phenomena were seen in 21.5%. Complications of chronic pancreatitis were revealed in 32.3%. Pyoseptic complications (11.2%), anicteric cholestasis (8.5%), subhepatic portal hypertension (8.0%), cholestatic jaundice (7.8%) were most common. Immunodeficiency states developed with long-term treatment of CP. A small portion (0.9%) of patients with CP developed pancreatic carcinoma. 3% of patients had deaths directly due to the active course of the disease whose causes were pyoseptic processes, pancreatic carcinoma and profuse hemorrhages from exulcerations of the duodenal postbulbar part.
A total of 97 patients with pancreatic carcinoma were examined with sonography, computed tomography of the pancreas and endoscopy of the stomach and duodenum. The tumor involved mainly the head of the pancreas in 69 (71.1%), the body in 21 (21.7%) and the tail in 7 (7.2%) patients. Two basic types of the disease were identified: disseminated in 83 patients and rare in 14 patients. The disseminated type included a central (45 patients) and a peripheral (38 patients) variant. The latter is classed as peripheral (n = 30) and paraduodenal (n = 8). The rare types included masked variants (n = 6), miniblastomas (n = 3), megablastomas (n = 2) of the pancreas, as well as thrombotic variants of the disease (n = 3). The highest diagnostic value of sonography and computed tomography was observed in intrinsic peripheral variants of carcinoma. Gastroduodenal endoscopy along with biopsy of suspected segments is highly diagnostic in paraduodenal variants of the disease.
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To make the II Marseilles Classification of Pancreatitis more applicable to everyday clinical practice, a new systemic approach is suggested basing on clinical, laboratory, CT and ultrasound evidence. Upon examination of 182 chronic sufferers with pancreatitis, interstitial--edematous, parenchymatous, fibrous--sclerotic (indurative), hyperplastic (pseudotumorous) and cystic variants of the disease were established in 34.6%, 30%, 21.1%, 4.4% and 9.9%, respectively. Clinical features typical for each variant of the disease and most common complications are reviewed.
Under analysis were diagnostic possibilities of clinico-instrumental methods in examination of 397 patients with acute pancreatitis. The integral method of examination included a general rentgenological examination, angiography, laparoscopy as well as echography and computer tomography. The reliable diagnostics of acute pancreatitis is known to be very complicated and requires a skillful combination of various research methods. The most rational scheme of the examination of patients suspected for acute pancreatitis is proposed.
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The authors analyse the results of the use of modern methods of morphological verification of a diagnosis in 23 patients with different diseases of the pancreas. The patients were subjected to 26 spot transcutaneous biopsies verified by computer-aided tomography or ultrasonic exploration. The morphological diagnosis was verified in 20 out of the 23 examinees (87%). Three patients with pseudocysts received curative manipulations under the control of computer-aided tomography and ultrasonic exploration, sanitation and sclerosing of the pathological cavities.
In 42 patients with various diseases of the liver 45 aimed percutaneous biopsies were performed. The morphological diagnosis of the disease was verified in 38 of the 42 examined patients (90.5%). After the diagnostic punctures 19 patients with cysts and abscesses of the liver were given different curative manipulations.
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