Ministry of Education, Science, Youth and Sports of Ukraine

Sumy State University

O. L. Sytnik, V. V. Leonov, V. Ju. Petrenko surgery. Emergency abdominal surgery

Study aid

Recommended by the Ministry of Education, Science,

Youth and Sports of Ukraine

Sumy

Sumy State University

2012

УДК 617.55

ББК 54.5,3я73

С 41

Reviewers:

V. I. Lupaltsov – corresponding member of Academy of Medical Sciences, Doctor of Medicine, professor of Kharkiv National Medical University;

O. V. Lighonenko – Doctor of Medicine, professor of Poltava Stomatological Academy;

Ju. L. Shalkov – Doctor of Medicine, professor of Kharkiv Medical Academy of Advanced Studies

Recommended by the Ministry of Education, Science, Youth and Sports of Ukraine as study aid for the students of higher medical educational institutions of the IV accreditation level

(letter № 1/11-1851 of 13.02.12)

С 41	Sytnik O. L. Surgery. Emergency abdominal surgery : study aid / O. L. Sytnik, V. V. Leonov, V. Ju. Petrenko. – Sumy : Sumy State University, 2012. – 189 p. ISBN 978-966-657-411-7

The study aid contains information about etiology, pathogenesis, and general principles of diagnosis and treatment of acute surgical abdominal pathology in accordance with new training program in Surgery for the students of higher medical educational institutions of the ІV accreditation level (Kiev, 2008). Information emphases are modern diagnostic and treatment techniques in emergency abdominal surgery.

Посібник містить інформацію про етіологію, патогенез, загальні принципи діагностики та лікування гострих хірургічних захворювань органів черевної порожнини, що відповідає новій навчальній програмі з хірургії для студентів вищих медичних навчальних закладів ІV рівня акредитації (Київ, 2008). Акцентовано увагу на сучасних методиках діагностики та хірургічного лікування гострих хірургічних захворювань органів черевної порожнини.

УДК 617.55

ББК 54.5,3я73

ISBN 978-966-657-411-7

© Sytnik O. L., Leonov V. V., Petrenko V. Ju., 2012 © Sumy State University, 2012

Contents

P.

Introduction	4
Acute appendicitis	5
Acute cholecystitis	23
Acute pancreatitis	35
Perforated peptic ulcer	50
Peptic ulcer acute hemorrhage	61
Bowel obstruction	74
Acute peritonitis	92
Hernias of abdominal wall	110
Tests for control	138
Situational problem tasks	165
Referenses	173
Appendix	176
Subject index	186

Introduction

The publication of this study aid is caused by the conversion to the credit – modular training system in concordance with new training program “Surgery” for students of higher medical educational institutions of the IV accreditation level (Kiev, 2008).

Surgery, especially emergency surgery, is very important for all physicians. It starts at the IV academic year after finishing fundamental disciplines such as pathologic anatomy, pathologic physiology, pharmacology, topographic anatomy, operative surgery and initial clinical disciplines: general surgery, propaedeutics of internal diseases. Surgery forms the basic knowledge for successful study of the special branches of internal diseases.

The general purpose is assimilation of theoretical and practical knowledge about aetiology, pathogenesis, typical clinical manifestations, and methods of diagnosis, conservative treatment, operative treatment, rehabilitation of acute surgical diseases for general practice physicians.

Concrete purposes are:

• interpretation of aetiology, pathogenesis, classifications, typical clinical manifestations of the most frequent acute surgical diseases;

• formation of algorithms of diagnosis, conservative and operative treatment, postoperative treatment and rehabilitation;

• differential diagnostics of acute diseases of abdominal cavity, retroperitoneal space and chest cavity;

• evaluation of the results of laboratory tests and additional methods of investigations in patients with surgical abdominal pathology;

• identification of the indications for laparoscopic and paracentetic (under ultrasonic or CT-scan control) techniques.