This journal is
indexed in Scopus
Year 2021 Vol. 29 No 4
GENERAL & SPECIAL SURGERY
V.I. PETUKHOV 1, V.I. DERKACH 1, S.N. ERMASHKEVICH 1, M.V. KUNTSEVICH 1, A.P. KUTKO 2
ANGIOPULMONOGRAPHY WITH NITROGLYCERIN TEST IN THE DIAGNOSIS OF ACUTE INFECTIOUS LUNG DESTRUCTION
Vitebsk State Medical University 1,
Vitebsk Regional Clinical Hospital 2, Vitebsk,
The Republic of Belarus
Objective. To develop a method for additional and differential diagnosis of acute infectious lung destruction (AILD) based on angiopulmonography with the nitroglycerin test.
Methods. Angiopulmonography with the nitroglycerin test was used in 10 patients with suppurative diseases of the lung and pleura for additional and differential diagnosis of AILD The method was used in such situations when chest computed tomography did not allow to determine unambiguously the presence and / or prevalence of necrosis of the lung parenchyma.
Results. In 3 patients with the lung abscess, a clear restriction of the decay cavity was registered with the preservation of the main blood flow and weakening of the parenchymal phase of the blood circulation along the periphery of the destructive area.
During the nitroglycerin test performance there was no change in the filling of the microvascular bed with contrast along the periphery of the decay cavity, which made it possible to determine the presence of parietal sequesters. According to the results of the study, the lung gangrene was diagnosed in 6 patients. At the same time, two variants of circulatory disorders were noted: the first - with preservation of the blood flow through the main vessels and with the absence of a parenchymal phase in the lesion focus, the second - with the violation of the main blood flow. In the affected area no change in blood flow was observed after the nitroglycerin test performance. Similar results of the study indicated the development of necrosis of the pulmonary parenchyma, which was subsequently confirmed during the operations performed. In the site of inflammatory infiltration of the pulmonary parenchyma with preserved main blood flow, the depletion of the parenchymal phase of blood circulation was determined, but after the nitroglycerin test, a pronounced enrichment of the vascular architecture to the parenchymal phase in the pneumonia affecting part of the lung was noted.
Conclusion. It has been established that AILD is characterized by irreversible changes in the vascular bed of the lung parenchyma in the lesion focus. Angiopulmonography with the nitroglycerin test is considered to be an additional highly informative method improving the early and differential diagnosis of AILD in difficult clinical situations.
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210009, Republic of Belarus,
Vitebsk, Frunze Av., 27,
Vitebsk State Medical University,
the Department of Hospital Surgery with the Course of the Advanced Training and Personnel Retraining
tel. mobile: + 375 29 890 64 42,
Derkach Vladislav I.
Petukhov Vladimir I., MD, Professor, Head of the Department of Hospital Surgery with the Course of the Advanced Training and Personnel Retraining, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
Derkach Vladislav I., Post-Graduate Student of the Department of Hospital Surgery with the Course of the Advanced Training and Personnel Retraining, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
Yermashkevich Siarhei N., PhD, Associate Professor of the Department of Hospital Surgery with the Course of the Advanced Training and Personnel Retraining, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
Kuntsevich Maksim V., Assistant of the Department of Hospital Surgery with the Course of the Advanced Training and Personnel Retraining, Vitebsk State Medical University, Vitebsk, Republic of Belarus.
Kutko Andrey P., Head of the Endovascular Surgery Department, Vitebsk Regional Clinical Hospital, Vitebsk, Republic of Belarus.