SU1262382A1 - Method for diagnosis of rupture of gastroenteric tract hollow organ - Google Patents

Abstract

The invention relates to surgery. The purpose of the invention is to accelerate the diagnostic method. A laboratory-analytical gas chromatograph is used to study gaseous substances from the abdominal cavity. Sample components are distributed between two phases: one of them is fixed (sorbent), the other is mobile (carrier gas). The output of components from the instrument column causes a signal, with the result that a curve or separation chromatogram is recorded on the recorder tape. Each pure component comes out with one peak. When written S S on the chromatogram of the peak of methane diagnose the gap hollow argon sl the gastrointestinal tract.

Description

The invention relates to medicine, more specifically to emergency surgery, and serves to diagnose defects of the hollow organs of the abdominal cavity of a traumatic, ulcerative, and other genesis.

The purpose of the invention is the acceleration of the method, as well as early diagnosis of defects in the hollow organs of the abdominal cavity, especially small sizes and not accompanied by a significant amount of discharge of the contents of the hollow organs and bleeding (which makes it difficult to diagnose methods accepted in the surgical clinic due to laparocentesis with sampling from abdominal cavity for subsequent gas chromatography).

The method is carried out as follows.

To investigate the gaseous substances obtained from the abdominal cavity, a gas-chromatograph gas chromatograph 3101 was used. The gas-chromatographic analysis 5 on which the instrument is based is a physical method of separating complex mixtures into components. The components of the sample are distributed between two phases: one of them is fixed (sorbent), the other is mobile (carrier gas). The output of components from the instrument column causes a signal, as a result of which a curve or separation chromatogram is recorded on the recorder tape. Each pure component comes out with one peak. The time from sample injection to the point of peak recording is called component retention time (Rt), which is different for different gases.

In the experiments and clinical studies, atmospheric air was used as a carrier gas, which was passed through a chromatograph system at a rate of 5 l / h. A chromatographic column 5 mm long was pre-filled with a sorbent (activated carbon). The working temperature of the column was la.c. Ambient temperature (2224 ° C). The movement speed of the recording tape in the recorder unit was 240 mm / h,

Example 11. Patient N., 45 years old, was admitted to the clinic with a referral diagnosis: blunt abdominal trauma, alcoholism. Delivered to the hospital after 3.5 hours from the moment of injury. Complaints of abdominal pain, dizziness, weakness. The condition of the patient is of average weight. The skin is a normal color. Torn wound right hand. Pulse, 100 beats / min, blood pressure 130/80 mm Hg The abdomen is somewhat swollen, the muscles of the anterior abdominal wall are tight in the upper sections. Shchetkin-Blumberg syndrome cannot be objectively assessed. - Attending in sloping places of the abdomen, no. Blood leukocytes 11,310z in t μl, hemoglobin 88 units, hematocrit 44/56. On a review radiograph of the abdominal cavity, free gas and liquid are not detected. Laparocentesis was performed, dry puncture was obtained. Imposed moderate pneumoperitoneum. (600 ml of air). Take you gas samples. The chromatographic analysis yielded a peak of methane 56 mm high, 78 seconds after the sample was introduced. Diagnosed rupture of a hollow organ. Urgent laparotomy. During the revision of the abdominal cavity, the small intestine was ruptured in the middle section up to 0.5 cm. The diameter was in the migrospinal margin. Produced closure of the defect of the wall of the small intestine drainage of the abdominal cavity.

Example 2, Patient K., 56 years old, medical history No. 7744, was admitted to the clinic on March 7, 1984, complaining of lower abdominal pain.

Guideline diagnosis: abdominal trauma is closed. Brain scaling. Along the way. an insight. According to the patient, about 7 hours ago he was hit by a passenger car. At home, he lost consciousness twice. At admission, the condition of the patient is moderate. The skin is pale. Vesicular breathing in the lungs, no wheezing, Pulse 100 beats / min satisfactory Fill, BP 100/70 mm Hg Tongue dried white coated. The stomach is the correct form, sparing with breathing. On palpation, moderate muscle tension is observed along the right lateral canal of the abdomen, here pain and moderate syndrome of Yetkina-Blumberg, hepatic dullness is preserved. Dullness in sloping areas of the abdomen is not detected. Blood test: zrozrotsity 3.5440 v

µl, hemoglobin 69 units, hematocrit 37/63, leukocytes 2A, 610z in 1 µl. A review of fluoroscopy of the abdominal organs - free gas was not detected. Laparocentesis produced, dry puncture taken. Take gas sample. A chromatographic analysis yielded a peak of methane with a height of 12 mm, 76 seconds after the introduction of the sample. Diagnosed rupture of a hollow organ. Rothi paw produced. When revision of the abdominal cavity revealed ileum rupture up to 1 cm in diameter in 1 m from the bauginovy valve. Produced closure of the bowel defect, drainage of the pulp cavity.

Example 3. Patient E, 47 leistory disease No. 860, was admitted to the hospital on 11 NEGAR of 1984 with a diagnosis of closed abdominal trauma. Contusion of soft tissues of the face. Alcohol intake. The time and circumstances of the injury failed. Complaints of moderate abdominal pain, difficulty breathing. Sotsie tion of a patient of average weight. Skin and visible mucous membranes of normal color, multiple bruises in the face. Vesicular respiration in the lungs. Pulse 74 beats / min satisfactory filling, BP 100/60 mm Hg, Art. Tongue dried, coated with white bloom. The stomach of the correct form, is not involved in the act of breathing. On palpation, spilled muscle tension of the anterior abdominal wall. Dullness in sloping areas of the abdomen is not detected. Hepatic dullness is saved. Slimpkin-Blumberg's positive is positive. Blood test: red blood cells 3.8-10 in 1 μl, hemoglobin 82 units. hematocrit 42/58, leukocytes 10,210 in i μl. On a survey fluoroscopy of the abdominal organs of free gas and fluid levels were not revealed. The laparocentesis is made - blood is received. A chromatographic analysis yielded a peak of methane up to 42 mm high. Diagnosed rupture of a hollow organ, intrablastic bleeding. Urgent laparotomy. A revision of the abdominal organs revealed a longitudinal rupture of the sigmoid colon over a length of up to 7 cm. A primary resection of a section of the intestine up to 10 cm with the formation of an anastomosis end to end and the application of a cecostomy was performed.

Claims (1)

Invention Formula A method for diagnosing rupture of a hollow organ of the gastrointestinal tract, including laparocentesis with subsequent gas chromatographic analysis, which is based on the fact that, in order to accelerate the method, gas is sampled from the abdominal cavity, it is examined by gas chromatography and if there is a peak on the chromatogram. methane, diagnose rupture of a hollow organ.