INTRA-ABDOMINAL BLEEDINGS IN THE STRUCTURE OF POSTOPERATIVE INTRA-ABDOMINAL COMPLICATIONS

Kh.Kh. ASOMOV, U.R. RISKIYEV, M.A. MIRSIDIKOV

Republican scientific center for emergency medical care, Tashkent, UZBEKISTAN

Purpose - analysis of early intra-abdominal postoperative complications based on the materials of the clinic. Total of 464 patients with postoperative intra-abdominal complications were examined within the period from 2003 to 2010, bleedings were observed in 36 (7.8%) of them. Among the patients there were - 14 (38.9%) men, and 22 (61.1%) women, aged between -36-65 years, average age - 52.0 years. The main causes of bleeding in early postoperative period were: bleeding from the cystic artery and gallbladder bed - 15 (41.7%), from appendix mesentery 9 (25.0%), from parenchymal organs - 4 (11.1%), from bed of spleen - 3 (8.3%), trocar puncture - 3 (8.3%), and greater omentum 2 (5.6%). First signs of a possible intra-abdominal bleeding required urgent intervention. In this case, laparoscopy was practically the only additional method that allowed to confirm bleeding, estimate its intensity, and sometimes, identify the source and reason. In case of non-intensive bleeding and with the adequate sanitation, laparoscopy could pass to the stage of surgical aid and elimination of bleeding. The main intervention in case of intensive bleeding, unstable hemodynamics, and unspecified location of bleeding in the early postoperative period was relaparotomy based on urgent indications. The scope of repeated operation in each case is determined individually subject to the source of bleeding and the nature of revealed changes. Thus, the rate of postoperative bleeding after surgery on abdominal organs is in direct relation with the quality of the first operation. As in the majority of cases, the main causes of this complication were technical errors during surgery, their prevention, first of all, consists in the improvement of qualifications of a surgeon, thorough haemostasis, as well as revision of the abdominal cavity before its completion.

Date: 2014-12-28; view: 905