OUR EXPERIENCE IN TREATMENT OF ENTEROATMOSPHERIC FISTULAS FORMED AS A RESULT OF MINE-EXPLOSIVE INJURY

A mine-explosive injury is a special type of injury, and in most cases, the surgeon encounters a victim with polytrauma, including an injury to the organs of the abdominal cavity. However, 87% of all penetrating wounds of the abdominal cavity are accompanied by intestinal damage, which in the future...

Full description

Saved in:
Bibliographic Details
Main Authors: Kyrylo Parkhomenko, Anastasia Drozdova, Kostiantyn Prokopenko, Ivan Parkhomenko
Format: Article
Language:English
Published: Danylo Halytsky Lviv National Medical University 2024-10-01
Series:Acta Medica Leopoliensia
Subjects:
Online Access:https://amljournal.com/index.php/journal/article/view/396
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1841557705224880128
author Kyrylo Parkhomenko
Anastasia Drozdova
Kostiantyn Prokopenko
Ivan Parkhomenko
author_facet Kyrylo Parkhomenko
Anastasia Drozdova
Kostiantyn Prokopenko
Ivan Parkhomenko
author_sort Kyrylo Parkhomenko
collection DOAJ
description A mine-explosive injury is a special type of injury, and in most cases, the surgeon encounters a victim with polytrauma, including an injury to the organs of the abdominal cavity. However, 87% of all penetrating wounds of the abdominal cavity are accompanied by intestinal damage, which in the future can lead to the formation of enteroatmospheric fistulas. The study aimed to improve the results of surgical treatment of patients with enteroatmospheric fistulas formed as a result of a mine-explosive injury with a penetrating wound of the abdominal cavity. Material and Methods. The results of the treatment of 17 victims with enteroatmospheric fistulas, which were formed as a result of a mine-explosive injury with a penetrating wound of the abdominal cavity, were analyzed. All patients were treated in the surgical department of the Communal non-commercial institution of the Kharkiv Regional Council "Regional Clinical Hospital" during 2022-2023. There were 9 (52.9%) female patients, 8 (47.1%) male patients. The age of the patients varied from 42 to 75 years. Results. The study shows that only 4 (23.5%) patients had isolated intestinal injury, the other 13 (76.5%) had combined and multiple injuries. All 13 patients (except for the intestinal injury) had shrapnel wounds and penetrating injuries to the limbs, of which 4 had a traumatic hemopneumothorax, 4 had kidney and retroperitoneal injury, 3 had liver injury, and 2 had pancreas and retroperitoneal injury. , in 2 - injury of the spleen, in 1 - violation of the integrity of the pelvic bones. A comprehensive approach to the treatment of patients was implemented. The first stage is the opening and drainage of an abscess in the presence of an abscess on the front abdominal wall. The second stage is the delimitation of the intestinal fistula with one's tissues or with the help of various "fistula adapters". Next, VAC bandages were installed for active drainage. After debridement, tissue defects of the anterior abdominal wall were plasticized with own tissues or ointment bandages were used, sites were formed for the calorimeter (if there is a discharge of intestinal contents from the fistula) or places for an ointment bandage (if there is no secretion of intestinal contents). Discussion. Enteroatmospheric fistula is a subtype of enterocutaneous fistula, and represents a connection between the gastrointestinal tract and the external atmosphere without a vascularized covering of soft tissues. Enteroatmospheric fistula can develop along any part of the gastrointestinal tract. Conclusions. We believe that the scheme of treatment of enteroatmospheric fistulas will help to achieve significant success in the treatment of this category of patients, and the proposed algorithm will make it possible to avoid the next possible laparotomy. Also, if we take into account the economic aspect, it is economically less expensive to treat enteroatmospheric fistulas according to this algorithm than to carry out a massive surgical intervention.
format Article
id doaj-art-3b7fd6963c634f26bf802bc9bd62a280
institution Kabale University
issn 1029-4244
2415-3303
language English
publishDate 2024-10-01
publisher Danylo Halytsky Lviv National Medical University
record_format Article
series Acta Medica Leopoliensia
spelling doaj-art-3b7fd6963c634f26bf802bc9bd62a2802025-01-06T10:49:52ZengDanylo Halytsky Lviv National Medical UniversityActa Medica Leopoliensia1029-42442415-33032024-10-01301-2233410.25040/aml2024.1-2.023396OUR EXPERIENCE IN TREATMENT OF ENTEROATMOSPHERIC FISTULAS FORMED AS A RESULT OF MINE-EXPLOSIVE INJURYKyrylo Parkhomenko0Anastasia Drozdova1Kostiantyn Prokopenko2Ivan Parkhomenko3Communal non-commercial institution of the Kharkiv Regional Council "Regional Clinical Hospital", Kharkiv, Ukraine; Kharkiv National Medical University, Kharkiv, UkraineCommunal non-commercial institution of the Kharkiv Regional Council "Regional Clinical Hospital", Kharkiv, Ukraine; Kharkiv National Medical University, Kharkiv, UkraineCommunal non-commercial institution of the Kharkiv Regional Council "Regional Clinical Hospital", Kharkiv, Ukraine; Poltava State Medical University, Poltava, UkraineKharkiv National Medical University, Kharkiv, UkraineA mine-explosive injury is a special type of injury, and in most cases, the surgeon encounters a victim with polytrauma, including an injury to the organs of the abdominal cavity. However, 87% of all penetrating wounds of the abdominal cavity are accompanied by intestinal damage, which in the future can lead to the formation of enteroatmospheric fistulas. The study aimed to improve the results of surgical treatment of patients with enteroatmospheric fistulas formed as a result of a mine-explosive injury with a penetrating wound of the abdominal cavity. Material and Methods. The results of the treatment of 17 victims with enteroatmospheric fistulas, which were formed as a result of a mine-explosive injury with a penetrating wound of the abdominal cavity, were analyzed. All patients were treated in the surgical department of the Communal non-commercial institution of the Kharkiv Regional Council "Regional Clinical Hospital" during 2022-2023. There were 9 (52.9%) female patients, 8 (47.1%) male patients. The age of the patients varied from 42 to 75 years. Results. The study shows that only 4 (23.5%) patients had isolated intestinal injury, the other 13 (76.5%) had combined and multiple injuries. All 13 patients (except for the intestinal injury) had shrapnel wounds and penetrating injuries to the limbs, of which 4 had a traumatic hemopneumothorax, 4 had kidney and retroperitoneal injury, 3 had liver injury, and 2 had pancreas and retroperitoneal injury. , in 2 - injury of the spleen, in 1 - violation of the integrity of the pelvic bones. A comprehensive approach to the treatment of patients was implemented. The first stage is the opening and drainage of an abscess in the presence of an abscess on the front abdominal wall. The second stage is the delimitation of the intestinal fistula with one's tissues or with the help of various "fistula adapters". Next, VAC bandages were installed for active drainage. After debridement, tissue defects of the anterior abdominal wall were plasticized with own tissues or ointment bandages were used, sites were formed for the calorimeter (if there is a discharge of intestinal contents from the fistula) or places for an ointment bandage (if there is no secretion of intestinal contents). Discussion. Enteroatmospheric fistula is a subtype of enterocutaneous fistula, and represents a connection between the gastrointestinal tract and the external atmosphere without a vascularized covering of soft tissues. Enteroatmospheric fistula can develop along any part of the gastrointestinal tract. Conclusions. We believe that the scheme of treatment of enteroatmospheric fistulas will help to achieve significant success in the treatment of this category of patients, and the proposed algorithm will make it possible to avoid the next possible laparotomy. Also, if we take into account the economic aspect, it is economically less expensive to treat enteroatmospheric fistulas according to this algorithm than to carry out a massive surgical intervention.https://amljournal.com/index.php/journal/article/view/396hypertensionchildrenmetabolic syndromewaist circumferenceadolescentshereditysleepiness
spellingShingle Kyrylo Parkhomenko
Anastasia Drozdova
Kostiantyn Prokopenko
Ivan Parkhomenko
OUR EXPERIENCE IN TREATMENT OF ENTEROATMOSPHERIC FISTULAS FORMED AS A RESULT OF MINE-EXPLOSIVE INJURY
Acta Medica Leopoliensia
hypertension
children
metabolic syndrome
waist circumference
adolescents
heredity
sleepiness
title OUR EXPERIENCE IN TREATMENT OF ENTEROATMOSPHERIC FISTULAS FORMED AS A RESULT OF MINE-EXPLOSIVE INJURY
title_full OUR EXPERIENCE IN TREATMENT OF ENTEROATMOSPHERIC FISTULAS FORMED AS A RESULT OF MINE-EXPLOSIVE INJURY
title_fullStr OUR EXPERIENCE IN TREATMENT OF ENTEROATMOSPHERIC FISTULAS FORMED AS A RESULT OF MINE-EXPLOSIVE INJURY
title_full_unstemmed OUR EXPERIENCE IN TREATMENT OF ENTEROATMOSPHERIC FISTULAS FORMED AS A RESULT OF MINE-EXPLOSIVE INJURY
title_short OUR EXPERIENCE IN TREATMENT OF ENTEROATMOSPHERIC FISTULAS FORMED AS A RESULT OF MINE-EXPLOSIVE INJURY
title_sort our experience in treatment of enteroatmospheric fistulas formed as a result of mine explosive injury
topic hypertension
children
metabolic syndrome
waist circumference
adolescents
heredity
sleepiness
url https://amljournal.com/index.php/journal/article/view/396
work_keys_str_mv AT kyryloparkhomenko ourexperienceintreatmentofenteroatmosphericfistulasformedasaresultofmineexplosiveinjury
AT anastasiadrozdova ourexperienceintreatmentofenteroatmosphericfistulasformedasaresultofmineexplosiveinjury
AT kostiantynprokopenko ourexperienceintreatmentofenteroatmosphericfistulasformedasaresultofmineexplosiveinjury
AT ivanparkhomenko ourexperienceintreatmentofenteroatmosphericfistulasformedasaresultofmineexplosiveinjury