Method for diagnosing abdominal cavity organ injuries |
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IPC classes for russian patent Method for diagnosing abdominal cavity organ injuries (RU 2308872):
A61B1 - DIAGNOSIS; SURGERY; IDENTIFICATION (analysing biological material G01N, e.g. G01N0033480000)
Method for predicting ectopia of uterine cervix in females of reproductive age / 2306569
It is necessary to monitor the content of follicle-stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), progesterone (P) in blood serum on the 7th, 14th, 21st d of menstrual cycle due to immunoenzymatic technique. At FSH values ranged 4.98-5.78 IU/l on the 7th d of menstrual cycle, 9.88-11.52 IU/l on the 14th d of menstrual cycle, 6.91-7.85 IU/l on the 21st d of menstrual cycle, LH ranged 5.11-5.75 mIU/l on the 7th d of menstrual cycle, 11.7-12.23 mIU/l on the 14th d of menstrual cycle, 5.66-7.18 mIU/l on the 21st d of menstrual cycle, E2 ranged 41.28-44.93 pg/ml on the 7th d of menstrual cycle, 134.78-143.92 pg/ml on the 14th d of menstrual cycle, 98.91-109.29 pg/ml on the 21st d of menstrual cycle, Pranged 1.02-1.53 nM/l on the 7th d of menstrual cycle, 1.31-1.79 nM/l on the 14th d of menstrual cycle, 6.80-7.16 nM/l on the 21st d of menstrual cycle one should diagnose the ectopia of uterine cervix in females of reproductive age.
Method for predicting hollow follicles syndrome / 2302639
Method involves determining luteinizing hormone concentration, follicle-stimulating hormone concentration, estradiol concentration, progesterone concentration, testosteron concentration in blood according to program ECO during the first days of menstrual cycle before superovulation stimulation. Prognostic criterion is calculated using the obtained data PC=ехр(K)/(1+ехр(K)), where Ехр(х) is the exponential function, K is the intermediate variable calculated from formula K=0.423+0.02хLG- 0.189хfSG-0.421хE2+0.3хP1-0.987хТs, where LG is the luteinizing hormone concentration in blood, IU/l; fSG is the follicle-stimulating hormone concentration in blood, IU/l; E2 is the estradiol concentration in blood, nmole/l; P1 is the blood progesterone concentration, nmole/l; Ts is the testosteron concentration in blood, ng/ml. Empty follicles syndrome is predicted using calculated PC value less than 0.5.
 Method for predicting clinical mammary gland carcinoma course / 2300111
Method involves determining tumor cells percent and estimating receptor color in semi-quantitative way. Positive cells proportion is recorded and reaction intensity is determined from formula H=3xA+2xB+1xC, where A is the intensively stained nuclei percent; B is the moderately stained nuclei percent; C is the mildly stained nuclei percent. Receptor distribution is determined in addition in tumor units of mammary gland carcinoma. Sites of positive and negative expression and various expression intensity sites being found, the expression is considered to be heterogeneous. Uniform receptor distribution being observed in the tumor irrespective of staining intensity degree, the expression is considered to be homogeneous. Homogeneous steroid hormone receptor expression being observed in tumor, favorable clinical disease treatment course is to be predicted. When heterogeneous, the prognosis is unfavorable.
Method for detecting extracranial metastases in metastatic brain injury patients / 2300110
Method involves determining cortisol hormone concentration in cerebral metastasis-ill patient blood prior to treatment beginning. Its concentration being found within the limits of 54.0 to 130.0 nmole/l, metastatic lesion foci are predicted to be available in other internal organs and tissues.
Method for predicting cerebral metastasis lesion foci in metastatic brain injury patients / 2300109
Method involves determining thyroxin hormone concentration in cerebral metastasis-ill patient blood prior to treatment beginning. Its concentration being found within the limits of 68.0-115.0 nmole/l, 1 to 3 metastatic lesion foci are predicted to be available. The concentration being from 38.0 to 50.0 nmole/l, more than 4 p metastatic lesion foci are predicted to be available.
Method for predicting extracranial metastases development in patients having metastases in brain / 2297005
Method involves determining adrenal glands cortex hormone cortisol content in blood. At its level below the bottom border of the norm making from 260.0 up to 450.0 nmole/l, within the limits of cortisol concentration fluctuations from 70.0 to 240.0 nmole/l, extracranial metastases development are predicted to occur in 1-3.5 months after primary examination.
Method for predicting physical growth and development of small children / 2291444
Method involves determining triiodothyronine content in peripheral blood serum of children of the second half-year of life having perinatal central nervous system injury manifestations and no signs of hypothyroidism. The value being equal to 0.69±1.34 ng/ml, the children are predicted to have small height to the third year of life.
 Method for carrying out monitoring of diabetes mellitus patients state and neurological and vascular complications development / 2291437
Method involves determining immune reactivity of blood serum with respect to insulin, to anti-insulin antibodies or their antigen-binding fragments, to anti-anti-insulin antibodies binding the antibodies to insulin and antigens to growth factor or their antigen-binding fragments and ANCA antigen. Blood serum immunoreactivity increase with respect to parameters under measurement relative to norm is used for determining diabetes mellitus neurological and vascular complications development.
 Method for predicting the phases of stress states / 2288475
In patient's blood one should detect the concentration of cortisol and fertile factors α2-microglobulin (AMGF), trophoblastic β1-1-glycoproteide (TBG) and α1-placental microglobulin (PAMG-1). The phases of stress states should be diagnosed by the coefficient calculated due to dividing the sum of AMGF and TBG concentrations by the sum of PAMG-1 and cortisol concentrations, moreover, the concentration should be expressed in % against average values in healthy persons. Coefficient's value being equal to 1.0-11 corresponds to the norm; at its value being 1.2-1.5 one should diagnose the phase of anxiety; at 0.7-0.9 - the phase of resistance; at 0.2-0.6 - the phase of exhaustion. The innovation provides the chance to program the flow of pathological process more accurately.
Method for predicting the development of gastrointestinal tract paresis in patients with vertebral traumas / 2286089
In patients with vertebral traumas for about 2-3 h after lesion one should simultaneously determine the level of hormone cortisol, malonic dialdehyde (MDA) in blood serum, and, also, the value of total bioelectric activity (TBEA) of gastrointestinal tract (GIT) and at cortisol values being 981.7 nM/l and higher, and MDA values - 8.35 mM/l and higher and values of TBEA being 387.75 mcV and lower it is possible to predict the development of GIT paresis.
Method for treating vasomotor and allergic rhinitis cases / 2308247
Method involves exposing superficial mucous membrane surface to laser radiation treatment inferior nasal turbinates form their posterior end towards the anterior one as two coagulation grooves drawn in parallel to each other. The contact treatment is carried out with distal light guide end face of high power semiconductor laser operating on wavelength of 0.83 nm, with radiation power of 5 W in continuous mode. Laser radiation duration is equal to 8-10 s per one nasal turbinate. The procedure is single.
Method for carrying out anterior interbody spondylodesis / 2308246
Method involves carrying out frontal access to vertebral bodies, removing central part of the intervertebral disk having closing plates with bone defect being formed. The bone defect is closed with bicortical bone cylindrical truncated cone-shaped transplant taken from huckle-bone in a way that lesser base diameter matches bone defect diameter. The transplant is introduced into the defect with its lesser base propping neighboring vertebrae bodies.
 Method for treating closed depressed fractures of frontal sinuses face walls / 2308245
Method involves carrying out supra-orbital frontotomy and reducing fracture zone. Frontonasal canal is revised prior to the supra-orbital frontotomy, Hemosisnus is removed and flexible catheter coiled in spiral is introduced into frontal sinus lumen through fracture line. Antibacterial therapy means is supplied via the catheter in postoperative period during 5-6 days and then, the catheter is to be removed.
 Method for shaping foot stump / 2308244
Method involves carrying out oblique excision of I and V metatarsal bone heads and next to it, transverse excision of II and IV metatarsal bone heads with trapezoid foot stump being created. Then, foot stump soft tissues are sutured layer-by-layer at several levels. Foot bottom muscle flap edge is sutured with U-shaped sutures to the foot back fascia on top of it. Created fascial aponeurosis duplicature suture line is arranged in proximal position with respect to muscle duplicature suture line. The I and V metatarsal bone heads excision is carried out at an angle of 45° with respect to cross-foot line.
 Method for preventing secondary bone fragment dislocation in treating fractures under plaster bandage in conservative approach / 2308243
Method involves measuring dimensions of segment under treatment with tape-line and plaster bandage is applied. The tape remains circumferentially freely movable after the plaster bandage becomes hardened. Soft tissue edema dynamics is controlled daily under immobilization conditions with plaster bandage by pulling free ends of the tape, their superposition and taking measurements. Studied segment circumference is calculated from formula: Q=P-(nx2), where Q is the studied segment circumference, P is the tape length, n is the measured tape end segment length. The plaster bandage is upgraded in due time as required corresponding to soft tissue edema reduction.
Surgical method for treating pelvic prolapse and rectocele cases / 2308242
Method involves carrying out combined spinal and intravenous anesthesia. Greater sexual lips are sutured to perineal skin on both sides. Diamond-shaped incision is done on posterior vaginal wall, the incision grows wide from top to bottom, and the incision bottom edge corresponds to the posterior vaginal wall bottom edge, and the incision top edge corresponds to the posterior vaginal wall bulging top edge. Rectovaginal partition is exposed upwards to posterior vaginal vault top, anterior muscle portions of rectum-lifting muscles are mobilized, and anterior fascia portions of the rectum-lifting muscles are cut along muscular fibers. Mirror is introduced into wound and vagina is lifted as high as possible towards entrance into small pelvis and then exposed posterior leaflets of the right and left anterior fascia portions of the rectum-lifting muscles are sutured to each other with absorbable synthetic sutures. Implant, surgical wavy trapezoid Prolene gauze is placed in wound with wider trapeze base being individually selected with distance between anterior portions of the rectum-lifting muscles in their attachment places adjacent to bottom branches of patient pubic bones, taken into account. The gauze has perpendicular arrangement of its fibers. The wider trapeze base is placed in proximal position and stretched from the posterior vaginal vault top to the operational access bottom edge. Its lateral edges are proximally fixed to periosteum of internal surface of the right and left pubic bone bottom branches at the places the rectum-lifting muscles are attached to them and also fixed with 2-5 interrupted sutures to the posterior vaginal vault and to the anterior rectum wall with nonabsorbable suture. Distal redundant narrow portion of stretched implant is dissected in the middle at the level of 1 cm above the lower edge of vaginal wound giving the implant trousers shape. Tunnels are bluntly created through the available separate 10-15 mm long incisions in internal sciatic tubercles edges projection area from skin to the lower lateral edges of rectovaginal partition wound and then each leg of trousers-shaped implant is brought out through the created tunnels to pireneal skin with some excess left. The implant is pulled catching each of the implant legs, straightened and stretched in operation wound on posterior fascia leaflets sutured to each other of the anterior portions of the rectum-lifting muscles with two longitudinal central absorbable suture rows 10-15 cm far from each other. Then anterior levatoroplasy is carried out above the implant with 3-4 interrupted absorbable sutures and implant legs are fixed through incisions in sciatic tubercles projection with interrupted nonabsorbable sutures to sciatic tubercles periosteum. Unused implant rest is cut off. Skin wounds are sutured. Redundant posterior vaginal wall residue restricted by incision is excised and the vaginal wound is repaired with isolated interrupted sutures.
Method for treating peripheral nerve injuries cases / 2308241
Method involves suturing injured nerve to nerve taken out of cadaver. The allorgaft is preliminarily held in preservative solution being nutrient medium TC-199, enriched in combination of antibiotics.
Method for closing soft tissue defects on pilary part of head / 2308240
Method involves cutting cutano-subcutaneo-aponeurotic head tissues from frontal head part to median line of occipital tubercle. The second incision of the same depth is done in transverse direction from one temporal region to the second one through the middle part of parietal region. Aponeurotic layer is dissected in each of produced four flaps on internal side in radial direction into three parts. Kirschner wires are introduced through all layers over flaps vertices. Threads are bound to the Kirschner wires and to Kramer splint embracing the head. Traction is applied by moving the threads over the Kramer splint.
 Method for forming renal peduncle under sclerosing pedunculitis conditions in performing nephrectomy / 2308239
Method involves exposing kidney from paranephric cellular tissue. Posterior renal pelvis wall is dissected in parallel to renal sinus from the lower boundary to the upper one. Two clamps are placed on renal peduncle and anterior renal pelvis wall. The tissues are transected over the clamps. Renal peduncle sump is ligated. The ureter is ligated and transected. Ureter stump and posterior pelvis wall are excised.
 Method for suturing duodenal stump / 2308238
Method involves transecting duodenum. Stump lumen is closed by suturing anterior and posterior walls. The first suture row is covered with the whole bulk of round ligament of liver by suturing all its tissues from right to left in transverse direction. Then, pancreas capsule is sutured with the same needle above the upper ulcer defect pole and seromuscular anterior stump wall as well. The second ligature is placed 2.5-3.0 cm below the first one suturing the round ligament of liver in the same way and pancreas capsule is sutured below the lower ulcer defect pole and seromuscular anterior stump wall as well. The ulcer defect being of large size, additional sero-serous sutures are placed between the ligatures after having tied them, to the left between peritoneal integument of the round ligament of liver and lateral ulcer boundary and to the right between peritoneal integument of the round ligament of liver and anterior stump wall.
 Method for treating the cases of destructive pancreaticonecrosis aggravated with retroperitoneal space infection / 2243725
Method involves applying one or two parallel through draining tubes having lateral perforations. Flow lavage of the retroperitoneal space with antiseptic solutions is carried out via the perforations at room temperature and cooled solutions are administered concurrently with vacuum suction. Omental bursa is concurrently drained using the two parallel through draining tubes. Flow lavage of the omental bursa is carried out using these tubes.
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FIELD: medicine. SUBSTANCE: method involves carrying out video laparoscopic examination. Hemorrhagic content volume being less than 150 ml with no hemolysis, hemorrhagic content pH is determined. The pH value being less than 6.6, aimed laparoscopic examination starts from the stomach; pH being equal to 6.7-6.9 - from gallbladder; pH 7.0-7.1 - from the intestine; pH 7.2-7.4 - from the spleen; pH 7.5-7.8 - from the liver. EFFECT: enhanced effectiveness in detecting visually nonobservable injuries.
The invention relates to medicine, namely to methods of diagnosis, and can be used in surgery for the diagnosis of organ damage of the abdominal cavity. As is known, the frequency of false-negative diagnostic errors in isolated abdominal trauma prior to the implementation of diagnostic laparoscopy and apariencia reached 15-20%compared with a concomitant injury 25-55% [1, 2, 3], overdiagnosis organ damage of the abdominal cavity at the closed abdominal trauma was 53% [4]. There are reports of successful use for the diagnosis of organ damage of the abdominal cavity apariencia in combination with peritoneal lavage and subsequent laboratory study aspirate [5]. It is also known that the volume of the streamed into the abdominal cavity of the blood can be determined at the time of laparoscopy, which is confirmed by the experience of pre - and intraoperative assessment of the magnitude of the bleeding. When a large hemoperitoneum (750-3000 ml) blood spread throughout the abdominal cavity, the depth of the streaks of blood in the side channels exceeds 25 mm, with loops of bowel are swimming in blood, with an average hemoperitoneum (500-750 ml) blood localized in sloping areas (pelvis, side channels), the depth of the streaks of blood in the side channels is less than 10 mm, with a small hemoperitoneum (100-500 ml) of blood is accumulated in one of the anatomical areas or small t the memory. Bleeding volume less than 100 ml looks like a large clot or seems to be "smeared" in a limited area of the abdominal cavity. With minimal bleeding traces of blood are defined along the side channels or between the loops of the intestines. It is known that when a small amount of hemoperitoneum it is necessary to determine the source of bleeding [5], since patients with minor damage to the gland, liver, mesentery with Capoterra less than 150 ml is possible to avoid an open surgical intervention. If the abdominal cavity more than 100 ml of blood with clots inappropriate mandatory identification of the source of bleeding or localization of the damage of a hollow organ, as it only delays the study was the volume of hemoperitoneum is an indication for laparotomy. Accompanied by bleeding damage of a hollow organ such as the colon, is determined by the appearance in the blood of impurities intestinal contents, peculiar smell, the dominance of signs of peritonitis at rupture or necrosis of the bowel wall due to post-disturbance in the blood supply. In the literature [6] there are indications that the erroneous diagnosis caused by damage to the organ of the abdominal cavity, when using videolaparoscopy, at the leading medical institutions put up 1.1%, due to the deviation of the performance of the laparoscopic studies anatomical features and localization, and extent of the pathological process, hindering full visualization and constraint resolution diagnostic ability of laparoscopy. Thus, further development of methods of diagnostics of organ damage of the abdominal cavity, based not only on the detection of blood, but a quick study of its properties is the actual problem in surgery. A study of patent and scientific and medical literature revealed the following methods of diagnosis of organ damage of the abdominal cavity. A known method for the diagnosis of penetrating wounds of the abdomen [7] by videolaparoscopy at which damage the internal organ set on the basis of detection of damage to the peritoneum. The disadvantages of the method are the difficulty in visualization of the peritoneal cover the greater part of the intestine, rear-diaphragmatic surface of the liver and upper pole of the spleen, as well as the underestimation of the clinical value and volume change properties of blood aspirated during laparoscopy. A known method for the diagnosis of penetrating wounds of the abdomen [8] by videolaparoscopy at which damage to internal organs is not established by visually detected defect in the wall of the body, and the presence of abdominal blood and isicelo content. The disadvantage of this method is the possibility of obtaining false-negative result if the damage is of a hollow organ of the minimum size, especially of the proximal small intestine, when the moment of injury less than 6-8 hours. In this case, visually it is impossible to determine the pathological staining blood, intestinal contents or detect fibrin overlay on the damaged area of intestine. As with the previous analogue, the method does not involve research on the biochemical properties of blood aspirated by laparoscopy. There is a method of determining the tactics of treatment of patients according to the laboratory determination of the concentration of erythrocytes in the washing solution at laparotomies [9]. When the concentration of red blood cells to 0.04×1012/l (calculated per 1000 ml of the leaching solution and the average concentration of red blood cells 4,0×1012/l), which corresponds to hemoperitoneum 10 ml, you can continue conservative therapy with a thorough dynamic monitoring of patients and the nature of flow in the drainage. When the concentration of erythrocytes in the washing solution of 0.05×1012/l and above is acceptable for conservative therapy after laparoscopy with visual verification of no damage organs and bleeding. The disadvantages of the method are related to the lack of data on its use is lovanii to diagnose damage to the hollow body and tactics of conducting the patient upon detection of the aspirate the contents of the gastrointestinal tract or other pathological impurities, for example, bile, urine, and relatively large investment of time on microscopic examination of aspirated from the wash solution and the allocation of its results. There is a method of determining an infected effusion in the abdominal cavity and the method of treatment of diseases accompanied by effusion into the abdominal cavity [10]. 1. The method of determining the infected effusion in the abdominal cavity, including the study of effusion, characterized in that it determines the concentration of short-chain fatty acids. 2. The method according to claim 1, characterized in that the infection rate of effusion abdominal indicate the concentration of short-chain fatty acids more than 0.9 mg/g 3. The method according to claim 1, characterized in that to determine the qualitative composition of short-chain fatty acids. 4. The method according to claim 3, characterized in that the prevalence of percent propionic and butyric acids in the qualitative composition of short-chain fatty acids indicates the presence of exudate anaerobic microorganism populations. 5. The method according to claim 4, characterized in that the increase in the percentage of propionic acid over 25% and a reduction in the percentage of acetic acid is less than 50% indicates the presence of bacteria of the genus Bacteroides. 6. The method according to claim 4, characterized in that the increase in the percentage of butyric acid more than 25% and the reduction in the percentage of acetic acid is you are less than 50% indicates the presence of bacteria of the genera Clostridium and Fusobacterium. 7. The method according to claim 4, characterized in that when setting up the increase in propionic and butyric acids (more than 25% for each of these acids), and reduction in the percentage of acetic acid is less than 50% indicates the presence of a mixed anaerobic flora. 8. The method according to claim 3, characterized in that the predominance of acetic acid and isomers short-chain fatty acids indicates the presence of aerobic microorganisms. 9. The method according to claim 8, characterized in that the increase in the percentage of acetic acid over 50% indicates the presence of microorganisms of the genera E. coli, aerobic streptococci and staphylococci. 10. The method according to claim 8, characterized in that the increase in the percentage of acetic acid (>50%) and increase in the percentage of short-chain isomers of fatty acids more than 15% indicates the presence of aerobic microorganism populations possessing proteolytic activity. 11. A method of treatment of diseases accompanied by effusion into the abdominal cavity of the body, including the puncture cavity and antibacterial therapy, characterized in that punctate investigate the concentration and quality of the short-chain fatty acids, and antibiotic therapy is carried out with increasing concentrations of short-chain fatty acids more than 0.9 mg/g and choose an antimicrobial agent in accordance with the flora, the communication is authorized by the qualitative composition of short-chain fatty acids. 12. The method according to claim 11, characterized in that the treatment process control its performance on the quantitative and qualitative composition of short-chain fatty acids. The disadvantages of the method are related to the lack of data about its use to establish the fact of damage to the organ of the abdominal cavity, the source of bleeding and therefore the localization of damage in the abdominal cavity. The prototype of the present invention is a method of diagnostic laparoscopy [11], in which pneumoperitoneum impose one of the known methods, diagnostic laparoscopy is done with the use of video. Examination of abdominal cavity organs begin in the horizontal position of the patient. Subsequently, for sight inspection or other authority, managing the operating table, create a Trendelenburg position, Fowler, on the right and left side. Panoramic inspection to determine the condition of the abdominal organs, confirm the presence of fluid (blood, pus, serous effusion), fibrin adhesions. When sighting survey clarify the diagnosis, carry out a biopsy and aspiration of the liquid, and then differentiate it as astiticescuu, hemorrhagic, inflammatory exudate or blood. The authors noted [11]that not in all cases it is possible to visually determine its source. Differential the traveler performs diagnostics on the results of cytological examination and bacteriological culture. However, in the prototype revealed the following significant disadvantages: 1. The method virtually eliminates the possibility of diagnosing minimum (up to 5 mm in diameter) damage to the small intestine, since the latter quickly hiding nearby loops or great omentum, this is usually determined by the small hemoperitoneum. 2. To obtain the results of cytological examination and culture of the necessary additional costs of time and relevant experts, investigation methods of aspirated fluid cannot be performed directly in the operating room. The objective of the invention is to improve the treatment results of patients with abdominal trauma by early and correct diagnosis of organ damage of the abdominal cavity. This object is achieved in that when the volume of hemorrhagic content up to 150 ml and the absence of hemolysis determine pH hemorrhagic content, at pH less than 6.6 targeted videolaparoscopy start with the stomach at pH 6,7-6,9 - with the gallbladder and the duodenum, at pH 7.0, and 7.1 - intestine at pH 7,2-7,4 - with the spleen, at pH hemorrhagic content 7,5-7,8 - with the liver. The method is as follows. Pneumoperitoneum impose one of the known methods, diagnosticsconnectionstring manufactured using video. Examination of abdominal cavity organs begin in the horizontal position of the patient. Panoramic examination confirmed the presence of hemorrhagic content in the abdomen, aspirinum it. If the volume aspirational hemorrhagic content peritoneal cavity exceeds 150 ml, is the conversion of diagnostic videolaparoscopy. When the volume of hemorrhagic content up to 150 ml, absence of hemolysis hemorrhagic contents of the abdomen, as well as the explicit presence of pathological impurities therein intestinal contents, bile, urine, device, determining the pH of biological environments, such as Mr 220 or 225 Mr, set pH hemorrhagic content. At pH hemorrhagic content less than 6.6 sighting laparoscopy start with the stomach at pH hemorrhagic content 6,7-6,9 sighting laparoscopy start with the gallbladder and the duodenum, at pH hemorrhagic content of 7.0 to 7.1 sighting laparoscopy start with the bowel, at pH hemorrhagic content 7,2-7,4 sighting laparoscopy start with the spleen, at pH hemorrhagic content 7,5-7,8 sighting laparoscopy start with the liver. Then determine the volume of surgical intervention in accordance with the nature of the damage. The use of the proposed method is illustrated by the follow is their examples. Example 1. The patient Was, 28 years old, medical history, No. 1127, was admitted to the Department of traumatology No. 2 emergency hospital No. 2 21.09.04, with complaints of pain abdomen, weakness. According to the patient, for 1.5 hours before admission were injured in the accident. When seen in the emergency Department: the General state of moderate severity, hemodynamics relatively stable, BP 115/70 mm Hg, pulse 80, 1', CDC 19, the Abdomen is soft, with painful palpation in the right upper quadrant, the symptoms of irritation negative. Ultrasound liver under a narrow strip of free fluid. After treatment the skin under ITN in the lower left point of the Tracing made trocar puncture of the anterior abdominal wall, superimposed pneumoperitoneum 2,0 L. In review laparoscopy revealed in the abdominal cavity to 150 ml of hemorrhagic fluid. Hemorrhagic fluid aspirated. The parietal peritoneum, liver, spleen, intestine and gall bladder in areas accessible to inspection without damage. During videolaparoscopy conducted a quick study of hemorrhagic fluid in hemolysis by centrifugation, obvious signs of hemolysis no. The Mr device 220 has determined pH hemorrhagic content. pH hemorrhagic content of 6.8, the abdominal cavity is entered additional tools when sighting laparoscopy discovered rupture of the gallbladder 5 mm in diameter, performed typical endovideoneuro the practical cholecystectomy. In the abdominal cavity left PVC tube 5 mm Trocars are removed. Seized and treated with a solution of Odonata seams, aseptic bandage. The postoperative period without complications and was discharged on day 7 in a satisfactory condition. Example 2. Patient R., aged 32, case history No. 3422, was admitted to the Department of traumatology No. 2 emergency hospital No. 2 12.06.05 year, with complaints of abdominal pain, General weakness. According to the patient, for 1 hour before entering suffered from unknown, caused him injury by pain in the abdomen. When seen in the emergency Department: the General condition of moderate, stable hemodynamics, BP 120/80 mm Hg, pulse 82, 1', NPV 18 in 1'. Abdomen tense, palpation painful in the middle of the abdomen, symptoms of irritation slabopolozhitelnym. At the level of the umbilicus on the left srednechrochnoy line wound round shape, with dimensions of 0.3×0.3 cm, bleeding from a wound there. After treatment the skin under ITN in the lower left point of the Tracing made trocar puncture of the anterior abdominal wall, superimposed pneumoperitoneum 2,0 L. In review laparoscopy revealed in the abdominal cavity to 150 ml of hemorrhagic fluid. Hemorrhagic fluid aspirated. The parietal peritoneum in the projection wounds of the anterior abdominal wall is damaged, bleeding from a wound. Liver, spleen, intestine and gall bladder in areas accessible to inspection, without damaged the th. During videolaparoscopy conducted a quick study of hemorrhagic fluid in hemolysis by centrifugation, obvious signs of hemolysis no. The Mr device 220 has determined pH hemorrhagic content. pH hemorrhagic content of 7.0, in the abdominal cavity is entered additional tools when sighting laparoscopy found at 130-150 cm from the ligament distance of 2 scatter wound jejunum. In the abdominal cavity is entered additional tools, wounds sutured intracorporeal sutures. In the abdominal cavity left PVC tube 5 mm Trocars are removed. Seized and treated with a solution of Odonata seams, aseptic bandage. The postoperative period without complications and was discharged on the 8th day in a satisfactory condition. The use of videolaparoscopy in combination with a rapid study of the pH of aspirated hemorrhagic, peritoneal contents performed in patients with damage to the organ of the abdominal cavity allows directly during videolaparoscopy to establish the existence of available visualization in connection with the anatomical features and dimensions, organ damage of the abdominal cavity, as well as to determine the amount and schedule surgery. Sources of information 1. Bratash BM - Surgery, 1977, No. 4, p.14-17. 2. B. I. Nikiforov - Surgery, 1980, No. 2, p.72-76. 3. Cibulec G.N., Neither the new AV Journal of surgery, 1973, No. 1, s.89-91. 4. Pots SZ, V.S. Volkov - Surgery, 1976, No. 3, p.47-49. 5. Abdullayev EG, Fedenko V.V., Baranov GA and al. Endoscopic surgery, 2003, No.5, pp.42-47. 6. Abdullayev EG, Fedenko CENTURIES, Khodos, G.V. et al. Endoscopic surgery, 2003, No. 5, pp. 27-33. 7. Frantzides K. Laparoscopic and thoracoscopic surgery / Per. from English. - M-SPb.: "Publishing BINOM" - "Nevsky Dialect", 2000. - 320 S. 8. Shaposhnikov VI - Theory and practice, 2004, No. 1, p.15-19. 9. Tishenko CENTURIES - Surgery, 1987, No. 3, p.7-10. 10. And 2002122771 from 20.03.2004. 11. Endoscopic surgery: Fedorov I.V., H. Sigal, Odintsov CENTURIES): GEOTAR medicine, 1998. - 350 S. The way to perform diagnostic videolaparoscopy if damaged organ of the abdominal cavity, characterized in that when the volume of hemorrhagic content up to 150 ml and the absence of hemolysis, determine the pH of hemorrhagic content, at pH less than 6.6 targeted videolaparoscopy start with the stomach at pH 6,7-6,9 - with the gallbladder and the duodenum, at pH 7.0, and 7.1 - intestine at pH 7,2-7,4 - with the spleen, at pH hemorrhagic content 7,5-7,8 - with the liver.
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