1 research outputs found
Π‘ΠΈΠ½Π΄ΡΠΎΠΌ ΠΡΠ²Π΅ΡΠ΅ΡΠ°
According to the literature Bouveretβs syndrome is a rare disease with an unclear clinical picture and difficulties in diagnosis. The known diagnostic methods include X-ray examination, ultrasonography, computerized tomography, the endoscopic examination of the gastrointestinal tract. Researchers indicate that the most successful diagnosis can be made when combining ultrasound and contrast radiography. There isnβt a clear opinion about Bouveretβs
syndrome surgical treatment. Preference is given to the simple methods - enterotomy with the extraction of the biliary concrement leaving the elimination of the fistula and cholecystectomy for the second phase of treatment. In this case there appear a risk of the recurrence of biliary obstruction and the occurrence of cholangitis. A clinic case of a 62-year-old woman, who had difficulties in the diagnosis of biliary ileus has been described. The clinical picture has not corresponded to the X-ray examination results. The increase of obstruction syndrome and lack of the effect of conservative therapy have required a classical surgical treatment. In this case the solution of the problem has been reached by one stage treatment: cholecystectomy, enterotomy with gall stone extraction and the liquidation of gastric defect. The postoperative period has been complicated with a bilateral pleurisy, which has been
succesfully cured by carrying out the pleural puncture and antibiotic therapy.Π ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΠΈΠΈ Ρ Π΄Π°Π½Π½ΡΠΌΠΈ Π»ΠΈΡΠ΅ΡΠ°ΡΡΡΡ, ΡΠΈΠ½Π΄ΡΠΎΠΌ ΠΡΠ²Π΅ΡΠ΅ΡΠ° β ΡΡΠΎ ΡΠ΅Π΄ΠΊΠΎΠ΅ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠ΅ Ρ Π½Π΅ΡΡΠ½ΠΎΠΉ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΠΊΠ°ΡΡΠΈΠ½ΠΎΠΉ ΠΈ ΡΠ»ΠΎΠΆΠ½ΠΎΠΉ
Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΎΠΉ. Π‘ΡΠ΅Π΄ΠΈ ΠΌΠ΅ΡΠΎΠ΄ΠΎΠ² Π΅Π³ΠΎ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ ΠΈΠ·Π²Π΅ΡΡΠ½Ρ ΡΠ΅Π½ΡΠ³Π΅Π½ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ ΠΌΠ΅ΡΠΎΠ΄Ρ, ΡΠ»ΡΡΡΠ°Π·Π²ΡΠΊΠΎΠ²ΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅, ΠΊΠΎΠΌΠΏΡΡΡΠ΅ΡΠ½Π°Ρ
ΡΠΎΠΌΠΎΠ³ΡΠ°ΡΠΈΡ, ΡΠ½Π΄ΠΎΡΠΊΠΎΠΏΠΈΡΠ΅ΡΠΊΠΎΠ΅ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ ΠΆΠ΅Π»ΡΠ΄ΠΎΡΠ½ΠΎ-ΠΊΠΈΡΠ΅ΡΠ½ΠΎΠ³ΠΎ ΡΡΠ°ΠΊΡΠ°. ΠΡΡΠ»Π΅Π΄ΠΎΠ²Π°ΡΠ΅Π»ΠΈ ΠΎΡΠΌΠ΅ΡΠ°ΡΡ Π½Π°ΠΈΠ±ΠΎΠ»ΡΡΡΡ Π²Π΅ΡΠΎΡΡΠ½ΠΎΡΡΡ ΡΡΠΏΠ΅ΡΠ½ΠΎΠΉ
Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΏΡΠΈ ΡΠΎΡΠ΅ΡΠ°Π½ΠΈΠΈ Π£ΠΠ Ρ ΠΊΠΎΠ½ΡΡΠ°ΡΡΠ½ΡΠΌ ΡΠ΅Π½ΡΠ³Π΅Π½ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠΌ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ΠΌ. ΠΠ΅Ρ Π΅Π΄ΠΈΠ½ΠΎΠ³ΠΎ ΠΌΠ½Π΅Π½ΠΈΡ ΠΈ ΠΎΡΠ½ΠΎΡΠΈΡΠ΅Π»ΡΠ½ΠΎ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ
Π»Π΅ΡΠ΅Π½ΠΈΡ ΡΠΈΠ½Π΄ΡΠΎΠΌΠ° ΠΡΠ²Π΅ΡΠ΅ΡΠ°. ΠΡΠ΅Π΄ΠΏΠΎΡΡΠ΅Π½ΠΈΠ΅ ΠΎΡΠ΄Π°ΡΡΡΡ ΠΏΡΠΎΡΡΡΠΌ ΠΌΠ΅ΡΠΎΠ΄Π°ΠΌ β ΡΠ½ΡΠ΅ΡΠΎΡΠΎΠΌΠΈΠΈ Ρ ΡΠ΄Π°Π»Π΅Π½ΠΈΠ΅ΠΌ ΠΆΠ΅Π»ΡΠ½ΠΎΠ³ΠΎ ΠΊΠ°ΠΌΠ½Ρ, ΠΏΡΠΈ ΡΠΎΠΌ, ΡΡΠΎ Π»ΠΈΠΊΠ²ΠΈΠ΄Π°ΡΠΈΡ
ΡΠ²ΠΈΡΠ° ΠΈ Ρ
ΠΎΠ»Π΅ΡΠΈΡΡΡΠΊΡΠΎΠΌΠΈΡ ΠΎΡΡΠ°ΡΡΡΡ Π½Π° Π²ΡΠΎΡΠΎΠΉ ΡΡΠ°ΠΏ Π»Π΅ΡΠ΅Π½ΠΈΡ. ΠΠΎ, Π² ΡΡΠΎΠΌ ΡΠ»ΡΡΠ°Π΅ ΠΎΡΡΠ°ΡΡΡΡ ΠΎΠΏΠ°ΡΠ½ΠΎΡΡΡ ΡΠ΅ΡΠΈΠ΄ΠΈΠ²Π° Π±ΠΈΠ»ΠΈΠ°ΡΠ½ΠΎΠΉ Π½Π΅ΠΏΡΠΎΡ
ΠΎΠ΄ΠΈΠΌΠΎΡΡΠΈ ΠΈ
Π²ΠΎΠ·Π½ΠΈΠΊΠ½ΠΎΠ²Π΅Π½ΠΈΡ Ρ
ΠΎΠ»Π°Π½Π³ΠΈΡΠ°. ΠΡΠΈΠ²ΠΎΠ΄ΠΈΡΡΡ ΠΊΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠ»ΡΡΠ°ΠΉ ΠΆΠ΅Π½ΡΠΈΠ½Ρ 62 Π»Π΅Ρ, Ρ ΠΊΠΎΡΠΎΡΠΎΠΉ Π±ΡΠ»ΠΈ ΡΡΡΠ΄Π½ΠΎΡΡΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΈ ΠΊΠΈΡΠ΅ΡΠ½ΠΎΠΉ Π½Π΅ΠΏΡΠΎΡ
ΠΎΠ΄ΠΈΠΌΠΎΡΡΠΈ
Π±ΠΈΠ»ΠΈΠ°ΡΠ½ΠΎΠ³ΠΎ Π³Π΅Π½Π΅Π·Π°. ΠΠ»ΠΈΠ½ΠΈΡΠ΅ΡΠΊΠ°Ρ ΠΊΠ°ΡΡΠΈΠ½Π° Π½Π΅ ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²ΠΎΠ²Π°Π»Π° Π΄Π°Π½Π½ΡΠΌ ΡΠ΅Π½ΡΠ³Π΅Π½ΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΡ. ΠΠ°ΡΠ°ΡΡΠ°Π½ΠΈΠ΅ ΠΊΠ»ΠΈΠ½ΠΈΠΊΠΈ ΠΊΠΈΡΠ΅ΡΠ½ΠΎΠΉ
Π½Π΅ΠΏΡΠΎΡ
ΠΎΠ΄ΠΈΠΌΠΎΡΡΠΈ ΠΈ ΠΎΡΡΡΡΡΡΠ²ΠΈΠ΅ ΡΡΡΠ΅ΠΊΡΠ° ΠΎΡ ΠΊΠΎΠ½ΡΠ΅ΡΠ²Π°ΡΠΈΠ²Π½ΠΎΠΉ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ ΠΏΠΎΡΡΠ΅Π±ΠΎΠ²Π°Π»ΠΎ Ρ
ΠΈΡΡΡΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ ΠΊΠ»Π°ΡΡΠΈΡΠ΅ΡΠΊΠΈΠΌ ΡΠΏΠΎΡΠΎΠ±ΠΎΠΌ. Π Π½Π°ΡΠ΅ΠΌ
ΡΠ»ΡΡΠ°Π΅ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ ΠΏΡΠΎΠ±Π»Π΅ΠΌΡ Π΄ΠΎΡΡΠΈΠ³Π½ΡΡΠΎ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΠ΅ΠΌ ΠΎΠ΄Π½ΠΎΡΡΠ°ΠΏΠ½ΠΎΠ³ΠΎ Π»Π΅ΡΠ΅Π½ΠΈΡ: Ρ
ΠΎΠ»Π΅ΡΠΈΡΡΡΠΊΡΠΎΠΌΠΈΡ, ΡΠ½ΡΠ΅ΡΠΎΡΠΎΠΌΠΈΡ Ρ ΠΈΠ·Π²Π»Π΅ΡΠ΅Π½ΠΈΠ΅ΠΌ ΠΊΠ°ΠΌΠ½Ρ ΠΈ Π·Π°ΠΊΡΡΡΠΈΠ΅
Π΄Π΅ΡΠ΅ΠΊΡΠ° ΠΆΠ΅Π»ΡΠ΄ΠΊΠ°. ΠΠΎΡΠ»Π΅ΠΎΠΏΠ΅ΡΠ°ΡΠΈΠΎΠ½Π½ΡΠΉ ΠΏΠ΅ΡΠΈΠΎΠ΄ ΠΎΡΠ»ΠΎΠΆΠ½ΠΈΠ»ΡΡ Π΄Π²ΡΡ
ΡΡΠΎΡΠΎΠ½Π½ΠΈΠΌ ΠΏΠ»Π΅Π²ΡΠΈΡΠΎΠΌ, ΠΊΠΎΡΠΎΡΡΠΉ ΡΡΠΏΠ΅ΡΠ½ΠΎ Π²ΡΠ»Π΅ΡΠΈΠ»ΠΈ ΠΏΠΎΡΡΠ΅Π΄ΡΡΠ²ΠΎΠΌ ΠΏΡΠΎΠ²Π΅Π΄Π΅Π½ΠΈΡ
ΠΏΠ»Π΅Π²ΡΠ°Π»ΡΠ½ΠΎΠΉ ΠΏΡΠ½ΠΊΡΠΈΠΈ ΠΈ ΡΠ΅ΡΠ°ΠΏΠΈΠΈ Π°Π½ΡΠΈΠ±ΠΈΠΎΡΠΈΠΊΠ°ΠΌΠΈ