Appendix d Algorithm of diagnosis and treatment of acute pancreatitis
(obligatory)
Acute upper abdominal pain
Serum amylase and lipase levels
+
Ultrasonic
Enzyme levels are normal. Increasing of amylase Ultrasonic changing of and lipase levels.
pancreas are absent Ultrasonic changing of
pancreas are present
Signs of peritonitis
Yes No
Surgery Conservative treatment of
acute pancreatitis
Appendix e Algorithm of diagnosis and treatment of perforated ulcer
(obligatory)
Acute abdominal pain “due to stabbing with a dagger”
Abdominal X-ray
P
neumoperitoneum
Y
es
No
Gastroduodenoscopy Ultrasonic Laparoscopy
+
X-ray
Free liquid
Laparocentesis
P
erforated
ulcer
Open Laparoscopic
procedure repair
Appendix f Algorithm of diagnosis and treatment of bleeding ulcer
(obligatory)
Weakness, haematomesis, melena
E
mergency
endoscopy
Forrest I Forrest II Forrest III
Endoscopic haemostasis + conservative therapy
Evaluation of effect using clinical and endoscopic control
Forrest I Forrest II Forrest III
Absolute Relative Prolongation
indication indication of conservative for surgery for surgery therapy
Removal of all ulcer substrates is
necessary
(ulcer excision, partial gastrectomy)
Appendix g Algorithm of diagnosis and treatment of bowel obstruction
(obligatory)
Cramp-like abdominal pain, vomiting, constipation
S
igns
of peritonitis, strangulation
Yes No
Preoperative Abdominal X-ray +
preparation barium meal intake
Conservative treatment
Clinical evaluation +
X-ray control of
efficiency after
4–6 hours
No Yes
S
urgical
procedure