[The surgical treatment of perforated gastric and duodenal ulcers in middle-aged and elderly patients--an analysis of the 1985-1996 period].

The problem relating to perforated gastric and duodenal ulcers (PGDU) treatment is still pressing nowadays not only on account of the constant mortality rate (6.7-14.55 per cent according to personal data), but also on account of the lack of universally accepted tenets for their management, irrespective of the fact that the first operative interventions were done more than 100 years earlier, and so far, more than 50 palliative and radical procedures have been suggested.

[Hemorrhages from the gastrointestinal tract in middle-aged and elderly patients--the diagnostic-treatment procedures and mortality dynamics].

Hemorrhages from the upper part of the gastrointestinal tract pose serious surgical problems because of their rather elevated incidence, diverse etiopathogenesis, difficulties in diagnostic and therapeutic approach, and last but not least, owing to the high mortality rate. The incidence of patients with ulcers amount to 420 per 100,000 population, with those in advanced and old-age accounting for 15-40 per cent of the total number of affections. In this contingent ulcers run a course associated with a number of peculiarities conditioned by severe lesions, caused by an acute and prolonged blood loss, not infrequently associated with a serious co-morbidity typical of this age.

[Relaparotomy in middle-aged and elderly patients with peritonitis following a primary operation for digestive pathology--II].

The study covers 39,233 patients presenting biliodigestive pathology of which 12,230 in advanced and senile age, admitted to the emergency surgery section of the EMI "NI Pirogov" over a 12-year period (1985 through 1996). Of the total number, 6555 or 53.71 per cent are subjected to operation, with postoperative deaths amounting to 477 (7.

[A clinico-morphological parallel in peptic ulcer in middle and old age].

Based of clinical and obduction case material covering the period 1990-1997, the clinical profile, morphological patterns and therapeutic approach, consistent with the specificity of age, complications of the basic disease and presence of concomitant diseases, are summed up. The results of biopsy and necropsy studies, following statistical processing by the methods of variation and correlation analysis, afford information on the morbidity in either gender, as well as on the location and morphological patterns of ulcers, their complications and associated diseases. Over the period 1990 through 1997, a total of 5425 cases are subjected to obduction study.

[Diaphragmatic injuries in thoracoabdominal trauma].

In closed thoracoabdominal trauma the diagnosis rupture of the diaphragm is usually made in 5 per cent of the casualties. Over a 12-year period (1985 through 1996), in the Pirogov Institute are admitted 3018 cases presenting polytrauma. Among the contingent of closed thoracoabdominal trauma lesions to the diaphragm are registered in 151 cases, and among those with open injuries--in 21 cases.