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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_5302_Библиотеки_им_академика_М_И_Перельмана
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Langerhans Cell Histiocytosis
Definition: Rare disorder involving clonal proliferation of Langerhans
cells, leading to tissue damage.
Pathophysiology: Abnormal proliferation of Langerhans cells, a type of
immune cell.
Signs and Symptoms: Bone pain, skin rash, organ dysfunction based on
involvement.
Causes/Risk Factors: Unknown; often sporadic.
Medical Management: Chemotherapy, immunotherapy, targeted therapy.
Surgical Management: Lesion excision in localized cases.
Prognosis: Variable; depends on the extent of disease and organ
involvement.
Interesting Fact: Langerhans cell histiocytosis can affect people of all
ages, but it is most common in children.
Leriche Syndrome
Definition: Leriche syndrome is a type of aortoiliac occlusive disease
characterized by atherosclerosis leading to the obstruction of the distal
aorta and both iliac arteries.
Pathophysiology: Atherosclerotic plaques in the aorta and iliac arteries
cause reduced blood flow to the lower extremities.
Signs and Symptoms: Claudication, impotence, absent femoral pulses, and
cold, pale legs.
Causes/Risk Factors: Atherosclerosis, smoking, hypertension, and
diabetes.
Medical Management: Lifestyle modifications, antiplatelet medications,
and supervised exercise programs.
Surgical Management: Aortoiliac bypass surgery or angioplasty and
stenting.
Prognosis: Prognosis varies based on disease severity. Early intervention
can improve symptoms and prevent complications.
Interesting Fact: Leriche syndrome is often called “aortoiliac occlusive
disease of the elderly” and is more common in men.
Lipomas
Definition: Benign soft tissue tumors composed of fat cells.
Pathophysiology: Overgrowth of fat cells, forming a lump under the skin.
Signs and Symptoms: Soft, movable lump under the skin, often painless.
Causes/Risk Factors: Genetic predisposition, obesity.
Medical Management: Observation; surgical removal for cosmetic reasons
or if symptomatic.
Surgical Management: Excision of the lipoma.
Prognosis: Excellent; benign and rarely recur after complete removal.
Interesting Fact: Lipomas are the most common soft tissue tumors, and
they are usually harmless but can be removed if causing discomfort or for
cosmetic reasons.
Liver Abscess
Definition: Collection of pus in the liver, often due to bacterial infection.
Pathophysiology: Bacterial infection in the liver tissue, leading to abscess
formation.
Signs and Symptoms: Right upper quadrant pain, fever, jaundice, weight
loss.
Causes/Risk Factors: Biliary tract infection, abdominal trauma,
immunosuppression.
Medical Management: Antibiotics, drainage of the abscess if necessary.
Surgical Management: Percutaneous drainage or open surgical drainage
for large or complicated abscesses.
Prognosis: Good with prompt medical intervention; can be life-threatening
if untreated.
Interesting Fact: Liver abscesses can be single or multiple and are often
caused by bacterial spread from other parts of the body.
Lung Abscess
Definition: A lung abscess is a localized collection of pus within the lung
tissue, often resulting from bacterial infection.
Pathophysiology: Infection, aspiration, or pneumonia can lead to necrosis
and cavitation in lung tissue, forming an abscess.
Signs and Symptoms: Cough with foul-smelling or bloody sputum, chest
pain, fever, night sweats, and weight loss.
Causes/Risk Factors: Aspiration, pneumonia, immunosuppression,
alcoholism, or lung obstruction.
Medical Management: Antibiotics targeting the causative bacteria,
bronchoscopy for drainage, and supportive care.
Surgical Management: Surgical drainage or resection in severe or
complicated cases.
Prognosis: Prognosis is generally good with prompt and appropriate
antibiotic therapy. Delayed treatment can lead to complications.
Interesting Fact: Lung abscesses are often associated with aspiration of
oral contents, especially in individuals with impaired consciousness.
Lung Cancer
Definition: Malignant tumor in the lungs.
Pathophysiology: Genetic mutations due to exposure to carcinogens,
primarily smoking.
Signs and Symptoms: Persistent cough, hemoptysis, chest pain, weight
loss, shortness of breath.
Causes/Risk Factors: Smoking, exposure to asbestos, radon, family
history.
Medical Management: Chemotherapy, radiation therapy, targeted therapy,
immunotherapy.
Surgical Management: Lobectomy (removal of a lobe), pneumonectomy
(removal of an entire lung) in localized cases.
Prognosis: Varies widely based on the stage; early detection significantly
improves outcomes.
Interesting Fact: Lung cancer is the leading cause of cancer-related deaths
worldwide and is strongly associated with smoking.
Lymphedema
Definition: Swelling in one or more limbs, often due to the accumulation
of lymphatic fluid.
Pathophysiology: Impaired lymphatic drainage, leading to fluid retention
and swelling.
Signs and Symptoms: Swelling, heaviness, restricted range of motion,
recurrent infections.
Causes/Risk Factors: Lymph node removal (often due to cancer
treatment), lymphatic malformations.
Medical Management: Compression garments, manual lymphatic
drainage, exercise.
Surgical Management: Lymphaticovenous anastomosis, lymph node
transfer.
Prognosis: Chronic condition requiring lifelong management; can be
managed effectively with appropriate measures.
Interesting Fact: Lymphedema is a common complication of cancer
treatments like surgery and radiation therapy and requires ongoing care to
prevent complications.
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