Open AccessLiver abscesses ultrasonic semiotics and its significance for the surgery method choosing
Author(s) -
V. G. Yareshko,
S. G. Zhivitsa,
K. N. Otarashvili,
Vlastimil Novák,
И В Криворучко
Publication year - 2019
Publication title -
sučasnì medičnì tehnologìï
Language(s) - English
Resource type - Journals
ISSN - 2072-9367
DOI - 10.34287/mmt.2(41).2019.16
Subject(s) - medicine , stage (stratigraphy) , radiology , ultrasound , parenchyma , capsule , liver parenchyma , abscess , surgery , pathology , paleontology , botany , biology
Significant progress has now been made indiagnosing, treating, reducing complicationsand lethality at liver abscesses. This is due tothe displacement from the arsenal of surgery ofcomplex and traumatic abdominal or trans thoracesapproach to abscesses, which themselves created theproblem of the postoperative period, complicated thecourse of an already severe infectious pathology.Modern minimally invasive technologies havesignificant advantages, especially with regard tointerventional sonography, that is, the combinedproperties of diagnosis and treatment.Purpose of the study. To objectify the choice ofthe method of surgical intervention of liver abscesseson the basis of a new self-developed ultrasoundsemiotics of the stage of the formation of abscesses.Materials and methods. A comprehensiveexamination of 62 patients with liver abscesses wasbased on the study of the clinical picture of the liverabscesses, a bacteriological study of the contents,CT scan, and especially ultrasound, on the basisof which the ultrasound semiotics of the stagesof the formation of abscesses was developed andimplemented.Results and discussion. According to thepossibilities of ultrasound diagnosis of abscesses ofthe liver from the first signs of local inflammationin the liver to the final stage of formation of thepyogenic capsule, we identified four stages oftheir development: 1 stage – local inflammatorychanges of the parenchyma without itsdestruction; Stage 2 – destructive changes ofparenchyma without signs of distinct boundaries;Stage 3 – clear boundaries of destructive changeswith a non-expressed capsule; Stage 4 – clearformation of a capsule with complete destruction oftissues.The proposed ultrasonic semiotics allows us to determine the method of operation. Thus, at stages1 and 2, and in some cases in 3 stages, there isno alternative to puncture-drainage methods inresidual postoperative cavities. At stages 3 and 4, thereare more advantages in laparoscopic operations,in some cases laparotomic.Conclusions. the proposed classification ofultrasonic semiotics stages of the formation of liverabscesses most pathogenetically corresponds to themorphological changes of the abscess zone and,most importantly, is adapted to the choice of themethod of operation.Keywords: liver abscess, ultrasound semiotics,interventional sonography, laparoscopic surgery,abscess classification.