RU1774371C - Method of simulating liver abscess with rupture into abdomen - Google Patents

Abstract

Use in medicine, namely with experimental surgery, to simulate a liver abscess and associated peritonitis. SUMMARY OF THE INVENTION: a laparotomy is performed in dogs, using a trocar and a Jigley saw wire, they form a cavity in one of the 2x3 cm lobes of the liver into which a container filled with microbial suspension (for example, rubber) is placed, the proximal end of which is sealed with a ligature, the ends of which t under the skin, a container with a microbial suspension is perforated, the wound is sutured at the puncture site, which allows reproducing the model in 100% of cases and bringing it closer to the clinical course of 2 il.

Description

The method relates to the field of medicine, namely, experimental surgery

The prototype is a method of simulating a liver abscess by introducing a microbial suspension directly into the liver tissue (Roof VP et al. Reproduction of liver abscesses in rabbits in an experiment. Patol. Physiology and Expert, 1984, vol. 2, pp. 68-69)

This method proposes a model of a liver abscess bursting into the abdominal cavity.

This method has the following disadvantages. In the experiment, liver abscesses form very late on the 20-30th day after infection, not in all experimental animals and not in a specific area. The main one is that it is impossible to cause an abscess to break into the abdominal cavity

The aim of the invention is to provide an optimal model of an abscess of an abscess of a liver that has erupted into the abdominal cavity.

The method is carried out as follows.

Upper median laparotompu is produced in dogs under intravenous analgesia.

Peyeni is punctured with a trocar (diameter 0.2x0.3 cm) and its end is set about the thickness of the selected lobe of the liver. After removing the stylet, twice the folded wire of the Jigley saw with a protruding arcuate end is inserted into its lumen. Gradually moving forward and rotating the latter, a cavity 1 is formed in the thickness of the selected liver lobe of 2 animals 2 × 2 cm in size, into which the fingertip of a surgical glove or a baby inflatable balloon is filled with live microbial culture or fecal suspension (culture container 3). The proximal end is hermetically tied durable synthetic thread 4 At a distance of 6-7 cm from the first node 5, located on the tank with the culture, make the second b larger, used to dissect the abscess wall. The threads are drawn through two separate punctures of the wall of the formed cavity on the opposite

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side of the wound at the site of puncture of the liver tissue with a trocar, the distance between the threads should be 1.5-2 cm, and their ends (7) are fixed under the skin of the additional wound on the side wall of the abdomen. After that, a container with a microbial culture placed in the cavity of the liver lobe is perforated with a long straight needle through a trocar, and the wound at the puncture site is sutured tightly. At the same time, a container with a microbial culture with many small holes remains in the cavity we created, which leads to constant infection and suppuration of it along with strings 6-7 cm long, and a second large knot. The wound at the site of the puncture of the liver is sealed with a trocar tightly and sutured in layers on the abdominal wall.

Already from the second day, signs characteristic of the septic process appear, and after a week an abscess forms in all experimental animals. After 7-8 days, an additional wound is opened on the side wall of the abdomen, the ends of the threads are searched and sawing movements are performed. At the same time, the abscess wall is dissected with the second massive knot of synthetic thread and its contents are poured into the abdominal cavity, which leads to the development of peritonitis.

Subsequently, surgery is performed aimed at treating the abscess of the liver and peritonitis according to our chosen method and time. At the same time, it is possible to accurately determine the age of peritonitis, perform surgical interventions at the selected time taking into account the stage and phase of development of peritonitis, study the dynamics of all questions of interest in the treatment of complicated abscess of the liver and peritonitis, establish biochemical and morphological changes in experimental animals, clarify methods for their correction, to further transfer to clinical practice.

Example, 06/14/89, an outbred dog with a weight of 14 kg produced an upper-middle laparotomy. A trocar 3 mm in diameter punctured the right lobe of the liver. The stylet has been removed, and in its lumen a wire of the Jigley saw is doubled with a protruding arcuate end. Slow forward and rotational movement of the latter in the thickness of the lobe

a cavity is formed in the liver in which is filled with fecal lime hermetically tied with a long synthetic thread N 6 at the proximal end of the fingertip of the surgical glove. The ends of the threads were brought out under the skin of the additional wound through two separate punctures at a distance of 1 cm from each other. The tip of a rubber glove installed in the cavity of the lobe of the liver is perforated with a needle, and the wound at the site of the puncture of the liver is hermetically sutured with catgut. Layered sutures were applied to the wound of the anterior abdominal wall. On the second day, clinical signs of liver abscess appeared. After 7 days, the ends of the threads exposed under the skin were exposed, sawed by them and caused a breakdown of the liver abscess into the abdominal cavity and peritonitis.

The method allows simulating a reproducible in 100% of cases model of a liver abscess with a breakthrough into the abdominal cavity.

Claims (1)

SUMMARY OF THE INVENTION A method for simulating a liver abscess with a breakthrough in the abdominal cavity, comprising introducing a microbial suspension into the liver, characterized in that, in order to increase reproducibility and closer to the clinical course, a preliminary cavity is created in the liver and the microbial suspension is introduced as part of the container, in this case, the threads sealing it are brought out under the skin, then the container is perforated, and after the formation of the abscess with the help of threads, it is communicated with the abdominal cavity, Editor S. Kulakova  FI.G.2 Compiled by. T. Vazilo Tehred M. Morgenthal / Proofreader N. Tupitsa