Year 2013 Vol. 21 No 5

GENERAL AND SPECIAL SURGERY

B.M. DATSENKO, V.B. BORISENKO

MECHANICAL JAUNDICE, ACUTE CHOLANGITIS, BILIARY SEPSIS: PATHOGENIC RELATIONSHIP AND PRINCIPLES OF DIFFERENTIAL DIAGNOSTICS

Kharkov Medical Academy for Post-Graduate Education,
The Ukraine

Objectives. Clinico-morphological research is directed toward the study of pathogenetic relationship between biliary sepsis, mechanical jaundice and acute cholangitis as well as elaboration of the complex program differential diagnostics of these diseases.
Methods. The experimental-clinical research directed toward the study of pathogenic interrelations between mechanical jaundice, acute cholangitis and biliary sepsis has been carried out. The experimental part of the work has been done on 90 Wistar mature rats. The clinical part of the work was based on the study of 92 patients with the mechanical jaundice syndrome.
Results. Firstly it has been determined that besides the activity of two well- known factors of acute cholangitis pathogenesis as cholestasis and infection, the presence of the third pathogenic factor in the form of an lesion (destruction) of bile ducts mucosa is necessary for its origin. A number of diagnostically important criteria permitt to carry out the differential diagnostics between mechanical jaundice, acute cholangitis and biliary sepsis in a short time in all cases. Uncomplicated course of mechanical jaundice was diagnosed in 30 (32,6%), complicated course with the development of acute cholangitis was determined in 42 (45,7%) and biliary sepsis – in 20 (21,7%) patients.
Conclusions. The conducted study allowed to define the main factors of acute cholangitis and biliary sepsis pathogenesis. The worked out program of differential diagnostics of uncomplicated mechanical jaundice, acute cholangitis and biliary sepsis allow to perform the differential approach to the choice the rational treatment tactics, different for each disease, that is of great economical importance

Keywords: mechanical jaundice, acute cholangitis, biliary sepsis, pathogenetic interrelation, diagnostic program
p. 31 – 39 of the original issue
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Address for correspondence:
61037, Ukraina, g. Khar'kov, pr-t Moskovskii, d. 197, gorodskaia klinicheskaia bol'nitsa №2, kafedra khirurgii i proktologii Khar'kovskoi meditsinskoi akademii poslediplomnogo obrazovaniia,
e-mail: vabodoc@ukr.net,
Borisenko Vadim Borisovich
Information about the authors:
Datsenko B.M. An Honoured worker of science and technology, MD, professor of the chair of surgery and proctology of Kharkiv Medical Academy of Postgraduate Education.
Borisenko V.B. PhD, an associate professor of the chair of surgery and proctology of Kharkov Medical Academy for Postgraduate Education.
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