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Objective – to develop a method for diagnosing undifferentiated connective tissue dysplasia (UCTD) in patients with surgical pathology.Material and methods. The object of the study comprises 96 patients with surgical pathology who were treated in the department of thoracoabdominal surgery of the Shalimov National Institute of Surgery and Transplantology during 2017-2020 and 20 practically healthy people (comparison group). Laboratory, instrumental, histological, immunohistochemical studies and statistical analysis were performed.Results. The developed method contains an assessment of the most informative phenotypic and visceral signs of connective tissue pathology. The main attention is paid to the features that characterize the visceral manifestations of UDCT, especially functional and morphological changes of the digestive organs, which is extremely important in abdominal surgery. Ultrasonography is used to analyze the width of the white line of the abdomen and the condition of the abdominal and retroperitoneal organs, determining the presence of diastase of the rectus abdominis and splanchnoptosis. Studies of the effectiveness of the proposed method have shown that it can be used to diagnose UDCT in patients with surgical pathology, which is necessary to select effective treatment tactics and prevent complications in such patients.Conclusions. A method for diagnosing undifferentiated connective tissue dysplasia has been developed, which evaluates the most informative phenotypic signs of connective tissue pathology and considers the peculiarities of pathology in patients of a surgical hospital.

Objectives - to improve treatment results in patients with ventral hernia and the concurrent surgical diseases by means of the designed surgery tactics. Material and methods. The treatment of 834 patients with ventral hernia, aged from 18 up to 82 years, was analyzed. The group consisted of 196 men (23.5%) and 638 women (76.5%). According to the European Hernia Society (EHS) classification of postoperative ventral hernias the gate types were distributed in patients as follows: W1 - in 132 patients (15.8%), W2 - in 397 (47.6%), W3 - in 305 (36.6%), in 243 (29.1%) cases the hernias were recurrent. 394 (47.2%) patients had 597 simultaneous interventions. The treatment tactics for the patients with hernias and associated diseases was defined according to the designed classification. For the abdominal wall repair the 2 variants of the "tension-free" mesh repair technique were used. Results. Forced simultaneous interventions were performed in 34 patients when the intestinal loops adherent to the scar were situated in the hernia sac. In 27 cases the postoperative ventral hernia was combined to the intestinal fistulas, located out of the hernia area. 12 patients underwent herniolaparotomy conditioned by the intra-abdominal intestinal fistulas closure and small hernias size. To prevent the compartment syndrome in 3 patients with splanchnoptosis the right part of the colon was resected. 103 patients had the planned simultaneous operations including the laparoscopic cholecystectomy in 19 cases, 114 patients underwent the panniculectomy. The preventional appendectomy was performed in patients with the recurrent large hernias. In 140 cases the omentum resection was done due to the signs of the chronical strangulation and omentitis. Postoperative pulmonary artery thromboembolia was the death cause for 3 (0.4%) patients. Only 8 (0.9%) patients suffered the partial hernia recurrence. Conclusion. In patients with hernias the simultaneous operations are conditioned by the pathogenesis and do not affect the severity and frequency of wound complications in the postoperative period. A condition for the simultaneous interventions in patients with hernias is the necessary implementation of the combined techniques of the ventral tension-free mesh hernioplasty.

Gynecology sprang into existence as an offshoot from medicine to meet the demands of suffering womankind for more successful treatment of a train of symptoms, presumably due to disturbed conditions of the pelvic organs. Gynecologists first learned that a certain number of these symptoms could be relieved by replacing misplaced pelvic organs and by supporting them through mechanical means, but they soon learned that this relief was only temporary, and that better and more permanent relief could be obtained by repairing the faulty natural supports by means of a surgical operation, which soon led to the abandonment of pessaries. They then learned that many patients referred to them by physicians, who had been cured of all abnormal pelvic conditions, still had a train of grave disabling symptoms unaccounted for. These unfortunate patients were referred back to the physician, who pronounced them hysteric or dyspeptic, and treated them accordingly and with

The treatment of splanchnoptosis is one of the most difficult problems confronting the practitioner, and especially is this true of the rather extreme type of cases which fall into the hands of the internist. We need all the help we can get from every possible angle, mechanical, medicinal, etc. The pathology is many-sided and its successful therapeutics must be equally so. While attending to other features of treatment, in many cases mechanical support of some sort is absolutely essential. For many years I have been trying a great variety of mechanical supports as adjuvants in the treatment of this condition, including corsets, bandages of various sorts, with various modifications of the adhesive plaster support suggested by Dr. Rose. These adhesive strips, variously modified, have given me better results than anything else. Considerable difficulty, however, has been encountered on account of the extensive apl1"',| op, the plaster to the skin, the

Speculation is still rife as to the causes of the falling of the viscera from their respective positions in the abdominal space. It is generally admittedthat there is a constitutional type in which there is a symmetrical descent of all the organs, and many observers are agreed that many of the extreme types encountered are due to congenital anomalies or defects. According to Rosengart's theory, congenital splanchnoptosis implies the persistence'of the embryonic positions of all or part of the abdominal viscera, while the acquired forms imply the gradual reversion from normal to fetal positions. Arrest of any abdominal organ at certain stages of fetal development establishes the conditions that determine ptosis, and in order that the right kidney and the ascending colon shall attain their normal positions it is necessary for the colon to pass in front of and across the right kidney, and if this rotatory movement fail and

PROLEGOMENON In May, 1881,1Dr. Glenard of Lyons, France, made the observation that many cases of nervous diseases were accompanied by a prolapsed position of the stomach. He proved this by palpation and percussion, which were advanced by his technic to a degree hitherto unknown. He soon afterward found that the other abdominal structures were prone to prolapse, especially the transverse colon, and the right kidney. From the time of this discovery of Glenard we may very properly date an era in the development of the science of medicine.2 The profession of France very early recognized the importance of these observations, and we take a lively pleasure at this time of revision in bringing to light a statement made by Fereal, at a meeting of the Hospital Medical Society, Paris, Dec. 24, 1886. After discussing neurasthenia and enteroptosis, he thus proceeded: The studies of Glenard confirm the exactitude

We are not dealing with the obscure conditions of the gastro-intestinal tract as they arise, but mostly with the common pathologic states, often misinterpreted on account of the unsatisfactory methods of diagnosis at the present day. The subject is so broad that we have decided to restrict our paper to the size, position, and motility of the gastro-intestinal tract. Normal patients, or patients with splanchnoptosis with or without intestinal symptoms, constitute our particular theme. Cases of ulcer and malignancy have been omitted on account of limitations of space. All the cases under consideration have been studied first with regard to the physical signs and the ordinary tests for gastro-intestinal secretions and contents. The Rontgen ray has been used as an aid confirmatory agent indiagnosis. Whereas due consideration in every case has been given to the history, subjective and objective signs, and examination of secretions, we have found the previous diagnosis

EN MASSE DESCENT OF THE VISCERA In ptosis en masse, the abdominal visceral mass moves downward and forward, pushing the incompetent walls before it, without at first causing much change in the interrelations of the viscera, except that the more movable organs tend to descend farther and more rapidly than the less movable ones. This process is seen in its simplest form with the subject lying in the recumbent position when the descent of the diaphragm is insufficiently antagonized (fig. 4, c , in a preceding paper 1 ). In the supine position gravity acts in a ventrodorsal direction, and, for a time, offers an obstacle to mass descent, since it tends to hold the viscera toward their attachments to the posterior wall of the abdomen, while at the same time it reenforces the retaining powers of the anterior abdominal walls (fig. 1 A ). In the lateral recumbent position the direction of