Volume 04 Issue 02-2024
59
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
04
ISSUE
02
P
AGES
:
59-63
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
ABSTRACT
The article presents the results of treatment of gastric and duodenal ulcer perforation and its complications in 35
children aged 12 to 18 years. Cases of videolaparoscopic removal of gastric and duodenal ulcers performed in these
patientsIn 27 (77.2%) cases, it was successfully completed, and in 3 (8.6%) cases, conversion occurred. Traditional
"open" surgical interventions were performed in 5 (14.2%) patients. The information content of ultrasound and X-ray
methods of preoperative diagnosis was evaluated. In particular, the specific course of the disease and the results of
diagnosis and treatment of the clinical manifestations of the studied disease were analyzed. A comparative analysis
of videolaparoscopic and "open" surgical interventions for perforated ulcers of the stomach and duodenum was
conducted.
Research Article
POSSIBILITIES OF TREATING PERFORMATIVE ULCERS OF THE
STOMACH AND DUODENUM BY MEANS OF ENDOVIDEOSURGERY
Submission Date:
February 09, 2024,
Accepted Date:
February 14, 2024,
Published Date:
February 19, 2024
Crossref doi:
https://doi.org/10.37547/ijmscr/Volume04Issue02-08
Berdiev Ergash Abdullaevich
Tashkent Medical Academy Republican Children's Scientific And Practical Center Of Minimally Invasive And
Endovisual Surgery, Tashkent, Uzbekistan
Atakov Sarvar Sultanbaevich
Tashkent Medical Academy Tashkent, Uzbekistan
Faizullaev Tajiddin Sulaymonovich
Tashkent Medical Academy Tashkent, Uzbekistan
Kasimov Ulugbek Korkmasovich
Tashkent Medical Academy Tashkent, Uzbekistan
Mukhidinov Abdulla Umidilloevich
Tashkent Medical Academy Tashkent, Uzbekistan
Journal
Website:
https://theusajournals.
com/index.php/ijmscr
Copyright:
Original
content from this work
may be used under the
terms of the creative
commons
attributes
4.0 licence.
Volume 04 Issue 02-2024
60
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
04
ISSUE
02
P
AGES
:
59-63
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
KEYWORDS
video laparoscopy; children; gastric and duodenal perforation.
INTRODUCTION
Relevance of the problem:Complications of peptic
ulcer and duodenal ulcer, an important part of
pediatric surgical gastroenterology, are steadily
increasing [1, 2].Despite many years of experience in
the treatment of gastric and duodenal ulcer
perforation and continuous improvement of its
methods, many issues are still controversial and not
fully resolved.Based on the latest medical literature, it
can be said that duodenal ulcer in children occurs in
99% of cases, 0.5-0.75% - in the stomach, and in 0.25% of
cases, mixed types are observed. The most serious
complications are perforation of the stomach and
duodenal ulcer, which requires urgent surgery.
Purpose of work: to determine the expediency of
treatment, the effectiveness of diagnostic measures
and to study the results of endovideolaparoscopic
surgery of gastric and duodenal ulcer perforation in
children.
Research materials and methods:In 2012-2023, 35
patients aged 12 to 18 who underwent surgery with the
diagnosis of gastric and duodenal ulcer perforation at
the Republican Children's Minimally Invasive and
Endovisual Scientific and Practical Center were studied.
4 (22.3%) of them were girls, and 31 (77.7%) were boys.
Table #1
Distribution of patients by age and gender (n-35)
Gender of patients
age
total
12-15 years old
16-18 years old
Boys
11(31.4%)
20(57.1%)
31(88.5%)
Girls
1(2.9%)
3(8.6%)
4(11.5%)
total
12(34.3%)
23(65.7)
35(100%)
Results and their discussion: All patients were urgently
admitted to the surgical intensive care unit for
intensive treatment and preoperative preparation
after complete diagnostic tests. At the time of
Volume 04 Issue 02-2024
61
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
04
ISSUE
02
P
AGES
:
59-63
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
admission, 32 patients were in moderate condition,
and the remaining 3 were in severe condition. The
average duration of illness in all patients was up to six
hours. 85% of children had no "history of gastric and
duodenal ulcers". 34 (94.4%) patients had general
peritoneal symptoms, only one had local pain in the
epigastric area. General radiography of the abdominal
organs was performed in 28 patients (77.7 %) showed
the presence of air in the area under the diaphragm. 7
patients (22.3%) underwent EFGDS, and after the
examination,
repeated
abdominal
radiography
revealed the presence of free air under the diaphragm.
Gastric ulcer was found in 3 patients during EFGDS.
27(77.2%) ) surgical operation of suturing punctured
wounds by endovideolaparoscopic method was
performed in 1 child, and one child had a clinic of acute
appendicitis, surgical interventions were carried out
with a Dyakonovo-Volkovich incision in the right iliac
region.
Removal of gastric and duodenal ulcer perforation by videolaparoscopic method
Perforation of the duodenum was observed in 6 (17.2%)
children, and the wound was located in the upper part
of the duodenum (pars superior). In 7 (20%) children, a
perforated ulcer is located in the pyloric area of the
stomach. Stomach perforative ulcer was found in 5
(14.2%) patients, and it was found that the ulcer was
mainly located on the front surface of the stomach in
the greater curvature - in 3 patients and in 2 patients in
the lesser curvature of the stomach. The size of the
perforating wounds consisted of round sclerotic tissue
with a diameter of 3 mm to 9 mm. Taking into account
the condition of the outer surface of the wound,
smoothing of the wound edges was not performed.
Table #2.
Volume 04 Issue 02-2024
62
International Journal of Medical Sciences And Clinical Research
(ISSN
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2771-2265)
VOLUME
04
ISSUE
02
P
AGES
:
59-63
SJIF
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MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
Distribution of patients by localization of gastric and duodenal perforation
Localization of gastric and duodenal
perforation
Number of patients (%)
Stomach ulcer
29 (82.9%)
12 finger ulcer
6(17.1)
total
35(100)
Perforative ulcers of the stomach and duodenum were
sutured videolaparoscopically with two rows of
sutures (a nasogastric tube was inserted into the
stomach and its pyloric section). Taking into account
the occurrence of chemical burns on the peritoneum
due to the action of hydrochloric acid and bile with a
perforated gastric ulcer and duodenal ulcer in the
abdominal cavity, the tactics were as follows. All
patients were sanitized by washing the abdominal
cavity with 10-12 liters of ozone-physiological solution
and treated with an antiseptic solution (dioxidin), for
control, a drainage tube was left in the stomach
perforation
area
and
small
pelvic
cavity.
Postoperatively, patients were treated with standard
protocols for gastric and duodenal ulcers. All of them
were discharged home from the hospital in satisfactory
condition. No complications were observed in the
postoperative period. During the first three years,
courses of treatment against abdominal adhesion
disease were conducted. In the long-term period, all
patients underwent endoscopic examination for 6
months and one year - it was found that the ulcer of the
stomach and 12th finger was healed, and there were no
recurrent abdominal syndromes.
Conclusions:A comprehensive diagnostic program for
diagnosing perforated ulcers of the stomach and
duodenum is carried out using endovideolaparoscopic
methods. General radiography and, if necessary,
EFGDS are carried out in the vertical position of the
patient. The presence of perforation is an indication for
diagnostic laparoscopy with suturing of the gastric or
duodenal defect, and then it is recommended to wash
the abdominal cavity with an ozonophysiological
solution to minimize the effect of hydrochloric acid and
bile on the peritoneum. Minimally invasive treatment
methods are traditional methods for the treatment of
perforated gastric ulcers and duodenal ulcers. With the
help of endovideolaparoscopic technologies, the
technique of suturing wounds is reliable, the minimal
trauma of surgery allows early activation of patients,
patients reduce the time of day-patient treatment.
Volume 04 Issue 02-2024
63
International Journal of Medical Sciences And Clinical Research
(ISSN
–
2771-2265)
VOLUME
04
ISSUE
02
P
AGES
:
59-63
SJIF
I
MPACT
FACTOR
(2021:
5.
694
)
(2022:
5.
893
)
(2023:
6.
184
)
OCLC
–
1121105677
Publisher:
Oscar Publishing Services
Servi
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