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Biomedical subjects

I Viiachki

Publications and source records attributed to I Viiachki.

At least 37 records · Page 2Linked to original sources
PubMed1996

[The views and attitudes of the Clinic of Emergency Surgery of the Clinical Emergency Medical Center at the Queen Ioanna State University Hospital on the potentials of surgical endoscopy in upper digestive hemorrhages].

Transendoscopic sclerotherapy of esophageal varix in children and adults is introduced in the clinic of emergency surgery ever since 1973. In children aged 3 to 14 years presenting preportal block a 100 per cent survivorship is recorded 20 years after the manipulation. The outcome of endoscopy in adult patients is successful in 57.69 per cent. Perilesional sclerosing is introduced in the CES in 1982, with a complete and definitive hemostasis attained in 46.7 per cent of the cases. In 1983, transendoscopic electrocoagulation is practically implemented in the CES, with the rate of successfully cured amounting to 55.49 per cent. Having in mind the limitations and contraindications of therapeutic transendoscopic hemostasis in massive hemorrhages, particularly those of ulcerative origin, preference is given to the safer hemostasis by surgical means.

Adolescent↗
PubMed1994

[Our experience with treating acute noncalculous cholecystitis].

Based on a comprehensive literature survey, personal experience with the management of 89 patients, presenting acute noncalculous cholecystitis, is shared. All patients are clinically observed in the acute phase of the disease. In 60 cases the latter becomes manifest with recurrent attacks, and in 29 there are no previous signs or symptoms of biliary diseases. Diagnosis is made on the ground of active echographic and clinical observation. Conservative therapy is effective in 28 cases. The remainder (61) are operated at 1 to 4-day intervals after the onset of the disease because of persisting symptomatology and/or deterioration of the patient's condition. During laparotomy the gallbladder presents marked enlargement with thickened, exudate-imbibed wall. Cholecystectomy is done in all 61 cases. In twelve of them, owing to dilatation of the common bile duct and minimal serum bilirubin increase, stenosing papillitis is diagnosed by intraoperative cholangiography, treated by external biliary drainage and endoscopic sphincterotomy, undertaken after improvement of the general condition. Acute inflammation, free of fibrosis, with isolated foci of gangrene and necrosis of the bladder wall are histologically documented. In four senile patients presenting serious concomitant diseases, with exceptionally high operative risk, echographic percutaneous transhepatic cholecystectomy is resorted to, followed by antibiotic bladder instillations with a very good outcome. The summed up results of acute noncalculous cholecystitis treatment are estimated as very good.

Acute Disease↗
PubMed1994

[The treatment of acute cholecystitis complicated by mechanical jaundice].

After analyzing the summed up treatment results in 368 patients with acute cholecystitis, complicated by obstructive jaundice, the inference is reached that it is a matter of a complication, unfavourable in terms of prognosis, with a definite impact on both immediate and long-term therapeutic results. Early operative intervention following intensive preoperative preparation (including ERHPG with endoscopic papillosphincterotomy and ensuing biliary decompression, or echographic percutaneous cholecystectomy) contribute to control the acute inflammatory process in the gallbladder, and preclude the development of liver (or hepato-renal) failure against the background of obstructive jaundice. Proceeding from the severe, irreversible changes in liver and kidney, hardly responding to treatment, and persisting deterioration of the general condition, acute cholecystitis complicated by obstructive jaundice is defined as an emergency life-endangering condition, requiring a priority operative approach.

Acute Disease↗
PubMed1994

[Necretomy and prolonged local postoperative lavage in the surgery of necrotic pancreatitis].

Over an 8-year period, sixty-one patients with mean age 52.5 years are operated on for necrotic pancreatitis in the clinic of emergency surgery at the Faculty Hospital "Queen Giovanna"--Sofia. The initial prognosis of the severity of disease scores 4.5 points average according to Ronson's rating system. The indications for operative treatment are clinically determined and further specified by ultrasonographic echo-ranging and computerized axial tomography. Necrectomy associated with prolonged local postoperative lavage are used as a method considered the most adequate from tactical viewpoint. The criteria for this particular therapeutic approach are substantiated. At 19.6 per cent lethality the postoperative results are estimated as satisfactory, and fully consistent with worldwide experience along this line.

Acute Disease↗
PubMed1993

[Biliary ileus].

This is a report on nine cases presenting biliary ileus. All patients undergo operative management. Two female patients present Bouveret's syndrome. The inference is reached that gallstone induced intestinal obstruction is characterized by atypical clinical patterns, conditioning in turn the diagnostic difficulties encountered, and the necessity to undertake operative treatment against the background of advanced ileus. The latter is one of the rarest forms of intestinal obstruction. Biliary ileus treatment consists in the removal of small intestinal impatency. The concretion is pushed in oral direction, and its evacuation is successfully accomplished by enterotomy, duodenotomy or gastrotomy. Two fatal outcomes due to severe advanced form of ileus are reported.

Aged↗
PubMed1993

[Echinococcosis--the current surgical aspects].

Over the period 1985 through 1992, forty-four patients presenting echinococcosis (echinococcus of the liver--33 cases, lung--nine, and spleen--two), aged 12 to 79 years, are operated in the emergency surgery clinic of the State Faculty Hospital "Queen Giovanna". The up-to-date methods of diagnosing are comprehensively described, followed by illustration and discussion of the operative procedures used in the treatment of echinococcosis. The early and long-term results are estimated as satisfactory.

Adolescent↗
PubMed1993

[Our experience in the diagnosis and treatment of traumatic pneumothorax].

The clinical material summarized is derived from the observation of 150 patients. The accent is put on the faults in the X-ray interpretation of the pneumothorax and on the mistaken tactics in the treatment of the pneumothorax, which led to four lethal cases. The attention is drawn to the importance of the prompt physical study of traumatic patients, which gives the opportunity for prompt diagnosis and urgent adequate treatment. The indications have been precised relating pleurocentesis, pleural drain and when lacking aerostasis for thoracotomy.

Bulgaria↗
PubMed1993

[The problems of severe combined chest and heart trauma].

On the basis of the experience and the analysis of 3818 cases of combined chest traumas the injuries in different anatomical areas have been observed. A special place was given for the diagnostics, the variety of the clinical conditions, the treatment and the prognosis of the reasons for lethality in cases with such traumas. With the increase of the affected anatomical areas the lethality increases proportionally too. At double, triple, fourfold, fivefold and sixfold combinations we have respectively 6.35 to 100% lethality. The indications for early surgical treatment have been stated. The acute respiratory failure (decompensation) and the shock in the combined traumas have been discusses as well.

Emergencies↗
PubMed1993

[Aggressive muscular-aponeurotic fibromatosis. Its clinical picture and morphological study].

The authors report 24 cases with aggressive muscle-aponeurotic fibromatosis for the period 1985-1990. Eleven cases with proved fibrosarcoma have been studied as well. From the total 35 cases the authors have observed 5 cases with localization on the front abdominal wall in women, and the remaining cases are as follows: 9 patients with thoracic girdle (c. membri superioris); 9 patients--in the head area; 5--in the chest area; 12--in the limbs; 2--in the lumbar area.

Adolescent↗
PubMed1993

[The modern differential diagnostic possibilities in chordoma].

The authors report five cases with chordoma. The diagnosis has been determined histologically on the basis of the operative material. The chordomas have a slow growth and a tendency to infiltrate the adjacent tissues and organs. That makes their surgical treatment difficult. A characterizing feature for them is the tendency to make recidivations and the difficulty in setting the differential diagnosis in metastasis of light-cell carcinomas.

Aged↗
PubMed1993

[The basic principles of diagnosis and treatment in emergency surgery].

A review of the literature is made, in the attempt to establish the principles of the diagnosis and treatment in emergency surgery. They are listed as follows: 1. To preserve patient life and evaluate the functional capacity of the organism; 2. To establish emergency diagnosis; 3. To choose the method of treatment; 4. Method of operation. The guidelines in emergency surgery is to develop and perfect new methods of operation and new technical facilities, to raise the professional skill of the surgeon and to improve the organization of work in surgical clinics and departments.

Diagnosis↗
PubMed1993

[Acute rectal hemorrhage].

Problems of the diagnosis, tactics and treatment of acute rectal hemorrhage are discussed. A diagnostic-tactical plan for determining the cause, source, localization and degree of bleeding are discussed. A diagnostic-tactical plan for determining the cause, source, localization and degree of bleeding, the acquired temporary or definitive hemostasis and the degree of blood loss is presented. Adequate approach to acute rectal hemorrhage helps to shorten the operation time, to reduce the extent of preoperative resuscitation and decrease total and operative lethality.

Acute Disease↗