INDICATIONS FOR CAPSULE ENDOSCOPY IN CASES OF BLEEDING IN UPPER SEGMENTS OF GASTROINTESTINAL SYSTEM

B.I. SADIGOV, KH.G. HUSEYNOVA, Z.M. SHAMKHALOV, A.M. ALIYEVA

Scientific Center of Surgery named after acad. M.A. Topchubashov, Baku,AZERBAIJAN

In the course of the last decade there were issued scientific articles and information about the application of capsule endoscopy. According to the information, capsule endoscopy is of more significance in the diagnostics of diseases complicated by bleeding in small intestine. In such patients localization of the source and determination of the etiology of bleeding during gastroscopy or colonoscopy is impossible.

To determine the ratio of patients than can be exposed to capsule endoscopy were analysed results of endoscopic examinations carried out in patients with suspicions on gastrointestinal bleeding. Within 10 years total of 664 patients was examined in our clinic with the suspicion on the bleeding of higher gastrointestinal segments. The pathologies found out during the examinations include: duodenal cap ulcer 301( 45.3% ), gastric ulcer 125 (18.8 %), gastric tumor 20 ( 3.0 %), esophageal varix 65 (9.8%), Mellori-Veis syndrome 24 ( 3.6 % ), anastomotic ulcer 27 (4.2 %), erosive gastrobulbitis 58 (8.7 % ), erosive ulcerated esophagitis 20 (3.0 % ), esophageal tumor 4 (0.6 % ), leiomyoma of the stomach 2 (0.3 % ), gastric polyp 1 ( 0.15 % ), Burxave syndrome 1 ( 0.15 % ), source of bleeding was not found 16 (2.4% ).

It can be said based on the shown figures that duodenal cap ulcer was mostly encountered reason of bleeding. The second encountered reason was gastric ulcer. One of the significant issues was failure to find out the reason of bleeding in 2.4% of patients.

Thus, capsule endoscopy can be used in 2.4 % of patients during gastro-intestinal bleedings, especially for the detection of sources of bleeding that can be localized in small intestine.

BOERHAAVE'S SYNDROME.

B.I. SADIGOV, KH.G. HUSEYNOVA, B.I. BAYRAMOV, S.KH. MUSAYEV

Scientific Surgical Center named after M.A.Topchibashev, Research Institute of Pulmonology, K.G.B. No. 5, Baku. AZERBAIJAN

Boerhaave's syndrome was one of the rare pathologies of the esophagus. Clinical presentations of the syndrome include severe retrosternal pain and bleeding, appearing after severe vomiting. Rupture of cardioesophageal passage was the reason of the appearance of the syndrome. Unlike Mallory - Weiss syndrome, during Boerhaave’s syndromes not only the mucous membrane, but also the muscle layer rupture.

Clinical observation: the patient that entered the clinic with severe pain in the epigastric area with irradiation to the left side of the chest, which appeared after severe vomiting, was exposed to esophagogastroscopy, during which there was found a deep longitudinal defect cardioesophageal zone. Bleeding from the defect was also observed. After the investigation the patient had emphysema in the region of neck. The patient was urgently operated. During the operation the was found a defect of cardioesophageal zone with fistula on the left pleural cavity. The defect was sutured, pleural cavity was sanitized and drained. Over the past decade, in 664 patients with suspected bleeding from the upper gastrointestinal tract underwent gastroscopy, in 24 of them (3.6%) Mallory - Weiss syndrome was detected and only in one patient (0.15%) Boerhaave’s syndrome was observed.

CLINICO-IMMUNOLOGICAL EFFICACY OF LACTOFLOR AGENT

IN PATIENTS WITH PEPTIC ULCER DISEASE

G.B. SADRIDDINOVA, Sh.Y. ZAKIRKHOJAEV, D.A. PARPIBAEVA,
M.U. SALICHOV, R. ALIEV

45th Family Policlinic, Tashkent Medical Academy, Tashkent, UZBEKISTAN

Forty-five patients with duodenal ulcer disease in active stage have been randomised into three groups: I group (15 patients) received H2 – blocker, II (30 patients) - H2 – blocker+lactoflor. Lactoflor agent – natural immunocorrector, produced in Uzbekistan.

The results of the study showed that abdominal pain decreased faster in II group than in I group (p<0,05). After 4 weeks of treatment ulcerous cicatrices were revealed in 83 and 97% in I and II groups respectively. The increase of T-lymphocytes by 14% (p<0,05) was noted. The increase of T-cytes and T-helpers noted to be by 40% and 52% respectively (p<0,05) and also the decrease of B-lymphocytes, natural killers by 37, 59% respectivelyу (р<0,05) was noted.

PRESENTATION FORMS AND TREATMENT OF ERODED GASTRIC BANDS

SAMI S. AHMAD, SUFIAN AHMAD, V. PYLIAVETS

Obesity center, Gastriccenter, Stuttgart, GERMANY,

Jordan Obesity center/Jordan Hospital Jordan Hospital, Amman, JORDAN

Background: Patients treated with Gastric band (LAGB) are increasing in number. LAGB has proved to be an effective operation to reduce overweight significantly. Postoperative complications are diverse and need special attention. Intragastric band erosion is a serious complication which needs special attention.

Method: Between 2001-2010. we have performed 1700 LAGB-operations.1480 patients were available for follow up. We assessed retrospectively the erosion complications. and their management.

Results 6 patients (0.04%) presented with different symptoms indicating intragastric band erosions. One Patient presented with fluid collection within the Port.

One Patient had abdominal sepsis signs. Two patients were discovered incidentally in endoscopy due to lack of weight loss. Two patients was discovered intraoperatively during removal of the gastric band due to massive weight loss. The surgical Treatment of these cases was multimodal. We removed the band laparoscopically transgastric, only laparoscopically, or endoscopically,

Conclusion: gastric band erosion is a serious complication which has to be diagnosed and treated on time.

Date: 2014-12-28; view: 927