[Gastroscopy in the diagnosis of stomach and duodenal diseases].
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A total of 102 patients with peptic ulcer of the stomach and duodenum, chronic gastritis, and erosive gastritis were examined. A statistically significant increase in blood viscosity was recorded during the diseases enumerated. In peptic ulcer and chronic gastritis, the fibrinogen and hematocrit levels did not change quantitatively although quantitative changes in the fibrinogen level were likely to influence blood viscosity. Red cell aggregation was found to be increased, being the main factor responsible for blood viscosity deterioration. The authors studied the effect of cimetidine on blood viscosity in patients with peptic ulcer and the effect of peritol in chronic gastritis. These drugs were found to markedly reduce blood viscosity, as a result of which the circulation in the gastric mucosa improved, promoting the cure of patients with peptic ulcer. According to the authors' opinion, cimetidine, that blocks H2 histamine receptors, lessens the effect of histamine on red cell aggregation, thereby improving blood viscosity.
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Nineteen cases when the patients had different combinations of gastric disease with calculous cholecystitis are described. All the patients were subjected to simultaneous operations. No complications were noted. A conclusion is made that the simultaneous operation is the most rational method in such a combination of diseases. The authors believe that calculous cholecystitis can be responsible for postoperative complications after any operation.
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The data available in the literature on the incidence of duodenogastric reflux and its relation with diseases of the stomach and duodenum are controversial. A study was performed based on the results of 4256 primary endoscopies of the stomach and duodenum: 3673 in nonoperated patients and 583 in patients having undergone vagotomy and resection. For duodenogastric reflux one judged from the yellow coloration of the gastric juice and regurgitation of bile at the moment of examination. Reflux had 428 patients (10.05 per cent)--330 in the nonoperated group (8.98 per cent) and 98 in the operated group (16.81 per cent). Inference is drawn that duodenogastric reflux does not coincide in incidence with reflux gastritis and that causal relation might be searched between gastritis, reflux esophagitis and duodenitis, on the one hand, and duodenogastric reflux, on the other.
The results of diagnosis and treatment of diseases of the stomach and intestine associated with diseases of the abdominal organs: hiatal hernia (97 cases), commissural disease of the peritoneum (31), calculous cholecystitis (28), abdominal wall hernia (22) are presented. In 34 patients, 3 and more diseases were revealed. Simultaneous operations were performed in 181 patients. At the long-term period, a good result was noted in 68.6%, a satisfactory one--in 25.5%, and unsatisfactory result--in 5.9%. The substantiated performance of simultaneous operations in patients of the given category is a perspective trend in surgery, it ensures the high medico-social and cost effectiveness of treatment.
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