Case of surgical treatment of the heavy nonspecific ulcer colitis complicated by massive bleeding


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Abstract

Complex treatment of patients with nonspecific ulcerative colitis is one of the most difficult problems of modern gastroenterology and is characterized by ulcerative-destructive changes of its mucous membrane. The main indications for surgical treatment of patients with nonspecific ulcer colitis are its complications, as well as the inefficiency of multi-component conservative therapy. The case of treatment of a young patient suffering from ulcerative colitis complicated by bleeding is considered. The possibility of performing radical surgical interventions for complications of ulcerative colitis is shown. One of the most dangerous, life-threatening complications of ulcerative colitis is bleeding. Most operations in patients with bleeding are performed urgently in extremely adverse conditions, due not only to the severity of bleeding, posthemorrhagic anemia and significant violations of hemostasis, but also the presence of concomitant complications of nonspecific ulcerative colitis, as well as associated multiple organ dysfunction. Thus, during the hospitalization of the patient, which amounted to 48 days, the patient underwent 11 open surgical interventions. For proper treatment it took more than 25 liters of blood products. Attention is paid to the favorable long-term result of treatment of patients with this pathology. In the treatment of this category of patients should be aware of the possibility of using minimally invasive technologies. The urgency of the problem under consideration is increased due to the steady increase in the incidence of nonspecific ulcerative colitis, which is naturally accompanied by an increase in the frequency of complications and disability of patients, a significant part of whom are the most efficient and socially active patients aged 20-40 years, with the causes and mechanisms of their development are not fully known.

About the authors

I A Solovyov

Военно-медицинская академия им. С.М. Кирова

Санкт-Петербург

A M Pershko

Военно-медицинская академия им. С.М. Кирова

Санкт-Петербург

D A Surov

Военно-медицинская академия им. С.М. Кирова

Санкт-Петербург

O V Balura

Военно-медицинская академия им. С.М. Кирова

Санкт-Петербург

A V Shotik

Военно-медицинская академия им. С.М. Кирова

Санкт-Петербург

O V Babkov

Санкт-Петербургский научно-исследовательский институт скорой помощи им. И.И. Джанелидзе

Санкт-Петербург

A V Svyatnenko

Военно-медицинская академия им. С.М. Кирова

Санкт-Петербург

D K Savchenkov

Военно-медицинская академия им. С.М. Кирова

Санкт-Петербург

G V Martynova

Военно-медицинская академия им. С.М. Кирова

Санкт-Петербург

D P Kurilo

Военно-медицинская академия им. С.М. Кирова

Email: kurildns@yandex.ru
Санкт-Петербург

References

  1. Абдулхаков, С.Р. Неспецифический язвенный колит: совре- менные подходы к диагностике и лечению / С.Р. Абдулхаков и др. // Вестн. соврем. клин. мед. - 2009. - № 1. - С. 32-41.
  2. Борота, А.В. Субтотальная колонэктомия как первый этап хирургического лечения тяжелых форм неспецифического язвенного колита / А.В. Борота и др.// Вестн. неотложн. и восстановит. мед. - 2012. - № 2 (13). - С. 219-221.
  3. Ватутин, Н.Т. Неспецифический язвенный колит / Н.Т. Ватутин [и др.] // Архив внутренней медицины. - 2015. - № 4 (24). - С. 62-65.
  4. Григорьева, Г.А. Неспецифический язвенный колит и болезнь Крона: диагностика и лечение осложненных форм / Г.А. Григорьева и др. // Клин. перспективы гастроэнтерологии, гепатологии. - 2002. - № 5. - С. 34-39.
  5. Халиф, И.Л. Воспалительные заболевания кишечника (не- специфический язвенный колит и болезнь Крона): клиника, диагностика и лечение / И.Л. Халиф [и др.]. - М.: Миклош, 2004. - С. 28-31.
  6. Bates, G.S. An inquiry into the surgical treatment of ulcerative colitis / G.S. Bates // Am. J. Med. Sci. - 1951. - № 2 (222). - Р. 211-226.
  7. Greifer, M.K. Update in the treatment of paediatric ulcerative colitis / Greifer M.K. [et al.] // Expert. Opin. Pharmacother. - 2006. - Vol. 7, № 14. - Р. 1907-1918.
  8. Rutgeerts, P.N. Inflliximab for induction and maintenance therapy for ulcerative colitis / P.N. Rutgeerts [et al.] // N. Engl. Med. - 2005. - Vol. 353. - P. 2462-2476.
  9. Turner, D.А. Response to corticosteroids in severe ulcerative colitis: A systematic review of the literature and meta-regression / D.А. Turner [et al.] // Clin. Gastrjenterolog. Hepatol. - 2007 - Vol. 5. - P. 103-110.

Copyright (c) 2018 Solovyov I.A., Pershko A.M., Surov D.A., Balura O.V., Shotik A.V., Babkov O.V., Svyatnenko A.V., Savchenkov D.K., Martynova G.V., Kurilo D.P.

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