[Can the intra-abdominal hypertension be the cause of poly-organic insufficiency during the destructive pancreatitis?].

The results of measurement and dynamics of intra-abdominal pressure obtained in 129 patients with acute destructive pancreatitis are presented. It was revealed that in 78% cases the pancreatonecrosis is accompanied by increase in intra-abdominal pressure (IAP); the intra-abdominal hypertension have developed in 9,3% patients. The prolonged intra-abdominal hypertension in the patients with progressive pancreatonecrosis requires the performance of laparotomy, which contributes to decrease in intra-abdominal pressure.

[The outlook for the development and improvement of ambulatory polyclinic care].

Out-patients medical care development represent one of the main tasks of the military medical service reforming. The essential effort focuses on a pre-hospital stage of medical aid, i.e.

[Nonepithelial tumors of the stomach].

816 patients were operated on because of gastric tumors; in 55 cases they were nonepithelial. Lymphomas have been found in 18 cases, glomus tumors--in 13 cases, leiomyomas, neurinomas and lipomas--in 11 cases, carcinoid--in 7 cases, aberrant pancreas--in 5 cases, gastric wall cyst--in 1 case. In half of the cases tumors were malignant.

[The status and trends in the improvement of specialized medical care].

The article analyses the changes which have taken place during the last years in the functioning of the system of specialized medical care in the Armed Forces of Russian Federation. A new definition of this kind of medical care is given in this article, as well as its contents, components, and methods of its further improvement. The authors stress the positive results which were achieved by large multipurpose medical establishments with organic specialized medico-diagnostical units.

[The radionuclide diagnosis of post-gastric resection disorders].

The article studies the possibilities of radionuclide method in disclosing the basic postgastroresectional syndromes: dumping syndrome, duodenogastric reflux and afferent loop syndrome. After resection of stomach 92 patients were examined throughout a period from 1 to 10 years. During dynamic scintigraphy of liver characteristic changes were disclosed in biliary secretory system which could have diagnostic significance.

[Operations on the stomach with a Roux anastomosis].

In order to prevent complications such as reflux gastritis, reflux esophagitis, erosions, ulcers and tumors of the gastric stump the Roux anastomosis was used in 497 patients. Among them there were 194 patients after distal resection of the stomach, 239--after extirpation of the stomach, 45 after vagotomy, antrumectomy, 19 after reconstructive operations on the stomach. These patients had organic complications much more rarely: 3.

[Indications for and the effectiveness of the Nissen operation].

Fifty six Nissen operations and 42 fundorrhaphies+ were performed in patients with hiatal hernias, insufficiency of the lower esophageal sphincter as well as for prophylactic purposes as an addition to vagotomy. In remote periods under examination there were 78 patients, 36 of them had different disorders, most of them of functional character which can be easily arrested by conservative methods.

[Malignant tumors as cause of death of patients with duodenal ulcer].

A study of 269 cases of chronic duodenal ulcer showed cancer to be the cause of death in 131 (48.7%). Tumors of the lung, large bowel, prostate and kidney developed most frequently.

[Duodenogastric reflux and the pathomorphological picture of the stomach of patients operated on for duodenal ulcer].

The incidence and degree of gastroduodenal reflux and of pathomorphological alterations in the gastric mucosa were studied in 135 patients within the period from 3 to 25 years after the surgical treatment of ulcer disease of the duodenum.

[Results of the endoscopic observation of patients operated on for cancer of the large intestine].

219 patients radically operated on for large bowel cancer were followed up for 1-16 years. Polyps were detected in 81 patients (37%) (malignant ones--9.6%), relapse in anastomosis--9 (4.

[Prevention and treatment of early complications of selective proximal vagotomy].

When performing the selective proximal vagotomy the operations draining the stomach were shown to aggravate the existing disturbances of the motor-evacuatory function of the stomach, to result in the development of the dumping syndrome, duodenogastral reflux. The exclusion of the duodenum with the formation of gastroentero- and Y-shaped enteroenteroanastomoses is indicated in cases with the pronounced cicatricial-ulcerous alterations of the pylorobulbar zone preventing the performing of pyloroplasty after Finney and Miculicz.

[Pathology of the gastric stump].

The endoscopic examination of 293 patients has shown that the incidence and character of diseases of the gastric stump (ulcer, polyps, carcinoma) were dependent on the underlying disease, time after the operation and severity of the duodenogastric reflux. The authors substantiate necessity of a refluxing anastomoses in gastric resection.

[Expediency of preventive examination of the upper parts of the gastrointestinal tract].

Gastroscopic examination of 528 practically healthy people showed that every fifth person aged from 41 to 60 and every third one older than 60 had a focal pathology of the stomach such as cancer, polyps, errosion, ulcer etc. Prophylactic gastroscopy is shown to be necessary in people aged over 45.