A.V. VOLENKO¹, A.I. LOBAKOV², I.A. VOLENKO²

¹Russian Medical Academy of postgraduate education, 2/1 Barklaya St., Moscow, Russian Federation, 123995

²Moscow Regional Research and Scientific Clinical Institute named after M.F. Vladimirskiy, 61/2 Schepkin St., Moscow, Russian Federation, 129110

Volenko A.V. — D. Med. Sc., Professor of the Department of Urgent and General Surgery, tel. (495) 686-05-14, e-mail: volenko.a@mail.ru¹

Lobakov A.I. — D. Med. Sc., Professor, Head of the Department of abdominal surgery, tel. (495) 681-96-17, e-mail: volen-m101@yandex.ru²

Volenko I.A. — junior researcher of the Department of Abdominal Surgery, tel. (499) 189-01-87, e-mail: volen-m101@yandex.ru²

The article represents the analysis of treatment of 158 patients with immature outer intestinal fistulas. Therefore, principles of treatment of that pathology were formulated and objective diagnostic techniques were worked out based on that analysis — straight radiopaque fistula enterography and duodenography. The algorithm of immature intestinal fistulas diagnosis consist of: determination of the number and localization of intestinal fistulas, determination of the number of loss in value of intestinal chymus, airway of abductive part of the intestine, as well as study of the direct topography relative to the wound and sinus opening of adductive and abductive part of the intestine.

Key words: immature intestinal fistula, fistula enterography, duodenography, the algorithm of diagnosis.

REFERENCES

1. Savel’ev B.C. Rukovodstvo po neotlozhnoy khirurgii organov bryushnoy polosti [Guidelines for emergency surgery of the abdomen]. Moscow: Triada-Kh., 2005. 470 p.

2. Filimonov M.I., Podachin P.V., Stoyko Yu.M., Frantsuzov V.N. Posleoperatsionnye intraabdominal’nye oslozhneniya peritonita i sostoyaniya, trebuyushchie povtornogo operativnogo lecheniya [Postoperative intra-abdominal complications of peritonitis and conditions requiring repeat surgery]. Peritonit: Prakticheskoe rukovodstvo. Moscow: Litterra, 2006. Pp. 102-115 (Seriya “Prakticheskie rukovodstva”).

3. Vitsyn B.A., Blagitko E.M. Sformirovannye i nesformirovannye kishechnye svishchi [Formed and unformed intestinal fistulas]. Novosibirsk: Zap.-Sib. kn. izd-vo, 1983. 141 p.

4. Atamanov V.V. Lechenie bol’nykh s nesformirovannymi kishechnymi svishchami: avtoref. … dis. d-ra med. nauk [Treatment of patients with unformed intestinal fistulas. Synopsis of dis. Dr med. Sci.]. Moscow, 1985. 38 p.

5. Belokonev V.I., Izmaylov E.P. Diagnostika i lechenie svishchey zheludochno-kishechnogo trakta (Seriya “Trudnye voprosy prakticheskoy khirurgii”) [Diagnosis and treatment of fistulas of the gastrointestinal tract (Series «Difficult questions of practical surgery»)]. Samara: Perspektiva, 2005. 240 p.

6. Kanshin H.H. Nesformirovannye kishechnye svishchi i gnoynyy peritonit [Unformed intestinal fistulas and purulent peritonitis]. Moscow, 1999. 115 p.

7. Kolchenogov P.D. Obturatsiya kishechnykh svishchey [Obturation intestinal fistulas]. Moscow, 1957. 87 p.

8. Levchik E.Yu. Sovershenstvovanie metodov operativnogo lecheniya naruzhnykh kishechnykh svishchey: avtoref. … dis. kand. med. nauk [Improving methods of surgical treatment of external intestinal fistulas. Synopsis of dis. PhD med. Sci. ]. Ekaterinburg, 2004. 47 p.

9. Makarenko T.P., Bogdanov A.B. Svishchi zheludochno-kishechnogo trakta [Fistulas of the gastrointestinal tract]. Moscow: Meditsina, 1986. 144 p.

10. Volenko A.V., Rudin E.P., Kuprikov S.V. et al. Naruzhnye svishchi tolstoy kishki: printsipy diagnostiki i lecheniya. Sovremennye tekhnologii diagnostiki i lecheniya khirurgicheskikh zabolevaniy. Sb. nauch. tr. [External fistulas colon: principles of diagnosis and treatment. Modern technologies of diagnostics and treatment of surgical diseases]. Moscow, 2013. Pp. 41-45.