Plamen Chernopolsky - Academia.edu (original) (raw)
Papers by Plamen Chernopolsky
PubMed, 2015
Small intestine is the longest part of the gastrointestinal tract. It represents 75% of its lengt... more Small intestine is the longest part of the gastrointestinal tract. It represents 75% of its length and 90% of the mucosal surface. Benign tumors are observed at 3-6% and the malignant--1-3% of all cancers of all GI malignancies. Patients and results: 23 patients with small intestinal tumors between 2001 and 2014 were admitted in Second Department of surgery. They were comparable in age, location and tumor characteristics. The reasons for hospitalization of patients were following symptoms: bowel obstruction, abdominal pain, GI bleeding, anemia. The diagnosis was established on the clinical presentation, performance status and imaging procedures (CT and MRI). The histological types of the tumor were adenocarcinoma--56.5%, GIST--17.4%, sarcoma--9.3% NET--8.7%, and lymphoma--8.1%. Surgical treatment was performed in all patients and included tumor resection, followed by side-to-side or end-to-end anastomosis. Conclusion: Small intestinal tumors are characterized by a low frequency. Diagnosis is made in advanced stage of disease because of lack of symptoms and difficult determination of the clinical presentation. Surgery is the only method that allows radical treatment. Chemotherapy is recommended in patients with malignant small bowel tumors.
Scripta scientifica medica, Sep 26, 2019
INTRODUCTION: A liver abscess represents capsulated purulent focus in the liver parenchyma, due t... more INTRODUCTION: A liver abscess represents capsulated purulent focus in the liver parenchyma, due to bacterial, fungal or parasite invasion. In the recent years their frequency rate related to malignant diseases has increased, including abscesses in liver metastases. AIM: We present four cases of metastatic colorectacal carcinoma, associated with pyogenic liver abscess, which were treated in the Second Department of Surgery, St. Marina University Hospital, Varna. RESULTS: We registered synchronous metastases and in two patients and the remaining two had metachronous metastases. The average age of our patients was 60 years (range 45-80). The patients were operated on and the following interventions were performed-in one-segmentectomy; in two-liver resection with right hemicolectomy; in one-incision, biopsy and drainage; and in one-percutaneous drainage. We established the following systemic complications: pleural effusion in one patient, in one-arrhythmia, subphrenic abscess-in two patients. The bacterial strains showed K. pneumoniae in one patient, two-sterile and in one S. epidermidis. DISCUSSION: In the recent years a lasting tendency of increasing of the frequency rate of malignant diseases of the GIT has been observed. The liver abscesses complicating a malignant disease can be treated like an abscess due to benign pathology-via aspiration, drainage and antimicrobial therapy. Surgical treatment is applied in larger (more than 5 cm) abscesses or with colorectal cancer. The prognosis in these cases is unfavorable due to the malignant diseases and the higher frequency rate of the septic complications.
Варненски медицински форум (Varna Medical Forum), 2014
As a renal replacement therapy, peritoneal dialysis has been applied in the clinic since the 1970... more As a renal replacement therapy, peritoneal dialysis has been applied in the clinic since the 1970s. Compared with hemodialysis, it has a unique superiority since it requires only simple equipment and surgery and it is more effective at protecting residual renal function. In recent years, with significant improvement of the peritoneal dialysis connecting system and peritoneal dialysis solution biocompatibility, as well as increasing standartization of patients' training has become the best method of early renal replacement therapy for patients with end-stage renal disease. We present you a review of different techniques, the cost effectiveness and comparison of the most frequent complications and we share our ten years' experience in peritoneal catheter placement in our clinic.
Scripta scientifica medica, Dec 20, 2011
[EN] Obstructive jaundice is one of the most common problems in surgery. Biliary obstruction is a... more [EN] Obstructive jaundice is one of the most common problems in surgery. Biliary obstruction is a frequent clinical symptom occurring in neoplasms of pancreato-biliary system or metastases of carcinomas with another primary localization. In the last decades there is an increase of the number of patients with cancer causing biliary obstruction. Most of these patients are in a stage that does not allow radical surgical intervention. The decision which procedure to be used for these patients is still controversial. Less trauma inducing and high efficiency of mini-invasive methods of treating malignant diseases complicated by mechanical jaundice, determine the need for comparative evaluation of surgical, endoscopic and X-ray controlled methods of treatment aimed at making them altogether an optimum combination of treatment on advanced level. /////// /////// [BG] Иктерът с обструктивна генеза е един от всекидневните проблеми в съвременната хирургия. Билиарната обструкция е често срещащ се клиничен симптом проявяващ се при неоплазми на панкреатобилиарната система или метастази на карциноми с друга първична локализация. Малката травматичност и високата ефективност на миниинвазивните методи на лечение на злокачествените заболявания, усложнени с механична жълтеница, обуславят необходимостта от сравнителна оценка между хирургичните, ендоскопските и под рентгенологичен контрол методи на лечение, с цел изработването от всички тях на оптимално съчетание на лечение на съвременно ниво.
Scripta scientifica medica, 2013
Construction of a stoma is a surgical procedure which is performed in some bowel resections. Alth... more Construction of a stoma is a surgical procedure which is performed in some bowel resections. Although there is a high frequency of these procedures, there is an appreciable complication rate (20-70% of all cases). The most common complications are skin excoriation and irritation, prolapse, retraction, ischemia, parastomal hernia and stenosis. For a 13-year period (May 2001 - May 2013), 478 surgical interventions performed in the Second Department of Surgery were completed with temporarily or permanently colostomy or ileostomy. A total of 86 corrections of a stoma with different complications were performed, but only in 21 of the patients (4,3%) the previous operation was in our Department. The cases were analyzed by age, gender, BMI, form and cause for the first operation, stoma complications and morbidity rate. In the present communication, we share our experience with the treatment of stoma complications.
Scripta scientifica medica, 2016
Scripta scientifica medica, 2016
Варненски медицински форум (Varna Medical Forum), 2014
As a renal replacement therapy, peritoneal dialysis has been applied in the clinic since the 1970... more As a renal replacement therapy, peritoneal dialysis has been applied in the clinic since the 1970s. Compared with hemodialysis, it has a unique superiority since it requires only simple equipment and surgery and it is more effective at protecting residual renal function. In recent years, with significant improvement of the peritoneal dialysis connecting system and peritoneal dialysis solution biocompatibility, as well as increasing standartization of patients' training has become the best method of early renal replacement therapy for patients with end-stage renal disease. We present you a review of different techniques, the cost effectiveness and comparison of the most frequent complications and we share our ten years' experience in peritoneal catheter placement in our clinic.
Biomedical Journal of Scientific & Technical Research, Jan 26, 2021
Background: A fistula is an abnormal communication between two epithelialized surfaces. Bowel fis... more Background: A fistula is an abnormal communication between two epithelialized surfaces. Bowel fistula presents communication between the bowel lumen and the skin of the abdomen wall, two portions of the intestine or between the intestines and some other hollow organs. Patients and Results: 21 patients with bowel-cutaneous fistulas between January 2010 and December 2016 were admitted in the Department. The reasons for hospitalization of patients were following symptoms: bowel obstruction, abdominal pain, intestinal content draining from the abdominal incision, abdominal wall infection. Diagnosis was established on the clinical presentation, performance status and imaging procedures (ultrasonography, CT, and MRI). All of them had previous GI surgery. Surgical treatment was performed in all patients and included bowel resection, followed by sideto-side or end-to-end anastomosis, stoma construction and in some cases abdominal wall reconstruction with prosthesis. Conclusion: Despite significant advances in the management in last decades, bowel fistulas still remain a major clinical problem with serious mortality rate of 15-25 %. Operative treatment is necessary in 35 to 80 % of patients in order to achieve closure.
РЕЗЮМЕ Перитонеалната диализа навлиза широко в клиничната практика като заместител на бъбречната ... more РЕЗЮМЕ Перитонеалната диализа навлиза широко в клиничната практика като заместител на бъбречната функция през 70–години на ХХ век. Установено е, че морталитетът и морбидитетът свързани с диализния достъп са значително по-ниски при перитонеалната, отколкото при хемодиализата. Успехът на перитонеалната диализа се определя от наличието на функциониращ и траен достъп до коремната кухина, което зависи в по-голяма степен от оперативната техника, отколкото от вида на перитонеалния катетър. В настоящето проучване представяме различните видове оперативни техники за поставяне на перитонеални катетри, различните видове катетри, както и да споделим нашия десетгодишен опит при пациенти с ХБН, при които сме поставили перитонеални катетри.
Construction of a stoma is a surgical procedure which is performed in some bowel resections. Alth... more Construction of a stoma is a surgical procedure which is performed in some bowel resections. Although there is a high frequency of these procedures, there is an appreciable complication rate (20-70% of all cases). The most common complications are skin excoriation and irritation, prolapse, retraction, ischemia, parastomal hernia and stenosis. For a 13-year period (May 2001 - May 2013), 478 surgical interventions performed in the Second Department of Surgery were completed with temporarily or permanently colostomy or ileostomy. A total of 86 corrections of a stoma with different complications were performed, but only in 21 of the patients (4,3%) the previous operation was in our Department. The cases were analyzed by age, gender, BMI, form and cause for the first operation, stoma complications and morbidity rate. In the present communication, we share our experience with the treatment of stoma complications.
International Journal of Gastroenterology, 2021
Actinomycosis is an indolent infection that usually presents a diagnostic challenge to the physic... more Actinomycosis is an indolent infection that usually presents a diagnostic challenge to the physician. The most commonly affected zones are the cervicofacial, thoracic and abdominal areas. Abdominal actinomycosis although recognized for more than 150 years, is still wide unknown for most of the clinicians. Its various clinical manifestations are usually considered to present malignant process rather than infection. Intramural gastric actinomycosis is extremely rare clinical noosologic unit and usually the original source of infection is unknown. The usual clinical presentations include mild fever, epi- or mesogastric pain, weight loss, and bleeding from upper gastrointestinal tract. This chronic infection has tends to mimic malignancy. Gastric actinomycosis is very rare and with a good prognosis gastric disease. When established clinically, that is quite difficult diagnosis to be done before obtaining a surgical specimen. Although the findings are nonspecific, actinomycosis should be...
Acute diverticulitis is a disease with a wide clinical spectrum, ranging from a phlegmon (stage I... more Acute diverticulitis is a disease with a wide clinical spectrum, ranging from a phlegmon (stage I a) to localized abscesses (stages I b and II), to free perforation with purulent (stage III) or feculent (stage IV) peritonitis. The planned therapy of colonic diverticulitis is very difficult because preoperative diagnosis is uncommon and the method of treatment is usually decided at the time of laparotomy. While there is a little debate about the best treatment for mild episodes, uncertainty persists about the optimal management for severe episodes and complicated diverticulitis.
Introduction: Neuroendocrine tumors originate from chromaffin-like cells and are tumors with neur... more Introduction: Neuroendocrine tumors originate from chromaffin-like cells and are tumors with neuroendocrine function and malignant potential. In the majority of the cases, they affect the gastrointestinal tract and pancreas. In the diagnosis of primary pancreatic carcinoma, 95% of cases are adenocarcinomas, and the remaining 5% are asymptomatic neuroendocrine tumors.Aim: We report a case of NET of the pancreas localized in processus uncinatus.Results: The patient underwent an enucleation of the tumor. On histological examination: markedly cellular with mostly dispersed tumor cells, also some loose clusters, acinus-like formations, small sheets, rosette-like formations and ribbons. Immunohistological stains were performed with the following results: the epithelial component was positive fоr Synaptophysin(+), Chromogranin(+), CDX2(+), TTF1(-), Ki67<2%. There was a histological demonstration of the well-differentiated neuroendocrine carcinoma of the pancreas. Overall, the patient t...
[EN] Obstructive jaundice is one of the most common problems in surgery. Biliary obstruction is a... more [EN] Obstructive jaundice is one of the most common problems in surgery. Biliary obstruction is a frequent clinical symptom occurring in neoplasms of pancreato-biliary system or metastases of carcinomas with another primary localization. In the last decades there is an increase of the number of patients with cancer causing biliary obstruction. Most of these patients are in a stage that does not allow radical surgical intervention. The decision which procedure to be used for these patients is still controversial. Less trauma inducing and high efficiency of mini-invasive methods of treating malignant diseases complicated by mechanical jaundice, determine the need for comparative evaluation of surgical, endoscopic and X-ray controlled methods of treatment aimed at making them altogether an optimum combination of treatment on advanced level. /////// /////// [BG] Иктерът с обструктивна генеза е един от всекидневните проблеми в съвременната хирургия. Билиарната обструкция е често срещащ се клиничен симптом проявяващ се при неоплазми на панкреатобилиарната система или метастази на карциноми с друга първична локализация. Малката травматичност и високата ефективност на миниинвазивните методи на лечение на злокачествените заболявания, усложнени с механична жълтеница, обуславят необходимостта от сравнителна оценка между хирургичните, ендоскопските и под рентгенологичен контрол методи на лечение, с цел изработването от всички тях на оптимално съчетание на лечение на съвременно ниво.
Introduction : A liver abscess represents capsulated purulent focus in the liver parenchyma, due ... more Introduction : A liver abscess represents capsulated purulent focus in the liver parenchyma, due to bacterial, fungal or parasite invasion. In the recent years their frequency rate related to malignant diseases has increased, including abscesses in liver metastases. Aim : We present four cases of metastatic colorectacal carcinoma, associated with pyogenic liver abscess, which were treated in the Second Department of Surgery, St. Marina University Hospital, Varna. Results : We registered synchronous metastases and in two patients and the remaining two had metachronous metastases. The average age of our patients was 60 years (range 45-80). The patients were operated on and the following interventions were performed – in one - segmentectomy; in two - liver resection with right hemicolectomy; in one - incision, biopsy and drainage; and in one – percutaneous drainage. We established the following systemic complications: pleural effusion in one patient, in one – arrhythmia, subphrenic a...
Scripta Scientifica Medica, Apr 20, 2010
Journal of IMAB - Annual Proceeding (Scientific Papers), 2019
PubMed, 2015
Small intestine is the longest part of the gastrointestinal tract. It represents 75% of its lengt... more Small intestine is the longest part of the gastrointestinal tract. It represents 75% of its length and 90% of the mucosal surface. Benign tumors are observed at 3-6% and the malignant--1-3% of all cancers of all GI malignancies. Patients and results: 23 patients with small intestinal tumors between 2001 and 2014 were admitted in Second Department of surgery. They were comparable in age, location and tumor characteristics. The reasons for hospitalization of patients were following symptoms: bowel obstruction, abdominal pain, GI bleeding, anemia. The diagnosis was established on the clinical presentation, performance status and imaging procedures (CT and MRI). The histological types of the tumor were adenocarcinoma--56.5%, GIST--17.4%, sarcoma--9.3% NET--8.7%, and lymphoma--8.1%. Surgical treatment was performed in all patients and included tumor resection, followed by side-to-side or end-to-end anastomosis. Conclusion: Small intestinal tumors are characterized by a low frequency. Diagnosis is made in advanced stage of disease because of lack of symptoms and difficult determination of the clinical presentation. Surgery is the only method that allows radical treatment. Chemotherapy is recommended in patients with malignant small bowel tumors.
Scripta scientifica medica, Sep 26, 2019
INTRODUCTION: A liver abscess represents capsulated purulent focus in the liver parenchyma, due t... more INTRODUCTION: A liver abscess represents capsulated purulent focus in the liver parenchyma, due to bacterial, fungal or parasite invasion. In the recent years their frequency rate related to malignant diseases has increased, including abscesses in liver metastases. AIM: We present four cases of metastatic colorectacal carcinoma, associated with pyogenic liver abscess, which were treated in the Second Department of Surgery, St. Marina University Hospital, Varna. RESULTS: We registered synchronous metastases and in two patients and the remaining two had metachronous metastases. The average age of our patients was 60 years (range 45-80). The patients were operated on and the following interventions were performed-in one-segmentectomy; in two-liver resection with right hemicolectomy; in one-incision, biopsy and drainage; and in one-percutaneous drainage. We established the following systemic complications: pleural effusion in one patient, in one-arrhythmia, subphrenic abscess-in two patients. The bacterial strains showed K. pneumoniae in one patient, two-sterile and in one S. epidermidis. DISCUSSION: In the recent years a lasting tendency of increasing of the frequency rate of malignant diseases of the GIT has been observed. The liver abscesses complicating a malignant disease can be treated like an abscess due to benign pathology-via aspiration, drainage and antimicrobial therapy. Surgical treatment is applied in larger (more than 5 cm) abscesses or with colorectal cancer. The prognosis in these cases is unfavorable due to the malignant diseases and the higher frequency rate of the septic complications.
Варненски медицински форум (Varna Medical Forum), 2014
As a renal replacement therapy, peritoneal dialysis has been applied in the clinic since the 1970... more As a renal replacement therapy, peritoneal dialysis has been applied in the clinic since the 1970s. Compared with hemodialysis, it has a unique superiority since it requires only simple equipment and surgery and it is more effective at protecting residual renal function. In recent years, with significant improvement of the peritoneal dialysis connecting system and peritoneal dialysis solution biocompatibility, as well as increasing standartization of patients' training has become the best method of early renal replacement therapy for patients with end-stage renal disease. We present you a review of different techniques, the cost effectiveness and comparison of the most frequent complications and we share our ten years' experience in peritoneal catheter placement in our clinic.
Scripta scientifica medica, Dec 20, 2011
[EN] Obstructive jaundice is one of the most common problems in surgery. Biliary obstruction is a... more [EN] Obstructive jaundice is one of the most common problems in surgery. Biliary obstruction is a frequent clinical symptom occurring in neoplasms of pancreato-biliary system or metastases of carcinomas with another primary localization. In the last decades there is an increase of the number of patients with cancer causing biliary obstruction. Most of these patients are in a stage that does not allow radical surgical intervention. The decision which procedure to be used for these patients is still controversial. Less trauma inducing and high efficiency of mini-invasive methods of treating malignant diseases complicated by mechanical jaundice, determine the need for comparative evaluation of surgical, endoscopic and X-ray controlled methods of treatment aimed at making them altogether an optimum combination of treatment on advanced level. /////// /////// [BG] Иктерът с обструктивна генеза е един от всекидневните проблеми в съвременната хирургия. Билиарната обструкция е често срещащ се клиничен симптом проявяващ се при неоплазми на панкреатобилиарната система или метастази на карциноми с друга първична локализация. Малката травматичност и високата ефективност на миниинвазивните методи на лечение на злокачествените заболявания, усложнени с механична жълтеница, обуславят необходимостта от сравнителна оценка между хирургичните, ендоскопските и под рентгенологичен контрол методи на лечение, с цел изработването от всички тях на оптимално съчетание на лечение на съвременно ниво.
Scripta scientifica medica, 2013
Construction of a stoma is a surgical procedure which is performed in some bowel resections. Alth... more Construction of a stoma is a surgical procedure which is performed in some bowel resections. Although there is a high frequency of these procedures, there is an appreciable complication rate (20-70% of all cases). The most common complications are skin excoriation and irritation, prolapse, retraction, ischemia, parastomal hernia and stenosis. For a 13-year period (May 2001 - May 2013), 478 surgical interventions performed in the Second Department of Surgery were completed with temporarily or permanently colostomy or ileostomy. A total of 86 corrections of a stoma with different complications were performed, but only in 21 of the patients (4,3%) the previous operation was in our Department. The cases were analyzed by age, gender, BMI, form and cause for the first operation, stoma complications and morbidity rate. In the present communication, we share our experience with the treatment of stoma complications.
Scripta scientifica medica, 2016
Scripta scientifica medica, 2016
Варненски медицински форум (Varna Medical Forum), 2014
As a renal replacement therapy, peritoneal dialysis has been applied in the clinic since the 1970... more As a renal replacement therapy, peritoneal dialysis has been applied in the clinic since the 1970s. Compared with hemodialysis, it has a unique superiority since it requires only simple equipment and surgery and it is more effective at protecting residual renal function. In recent years, with significant improvement of the peritoneal dialysis connecting system and peritoneal dialysis solution biocompatibility, as well as increasing standartization of patients' training has become the best method of early renal replacement therapy for patients with end-stage renal disease. We present you a review of different techniques, the cost effectiveness and comparison of the most frequent complications and we share our ten years' experience in peritoneal catheter placement in our clinic.
Biomedical Journal of Scientific & Technical Research, Jan 26, 2021
Background: A fistula is an abnormal communication between two epithelialized surfaces. Bowel fis... more Background: A fistula is an abnormal communication between two epithelialized surfaces. Bowel fistula presents communication between the bowel lumen and the skin of the abdomen wall, two portions of the intestine or between the intestines and some other hollow organs. Patients and Results: 21 patients with bowel-cutaneous fistulas between January 2010 and December 2016 were admitted in the Department. The reasons for hospitalization of patients were following symptoms: bowel obstruction, abdominal pain, intestinal content draining from the abdominal incision, abdominal wall infection. Diagnosis was established on the clinical presentation, performance status and imaging procedures (ultrasonography, CT, and MRI). All of them had previous GI surgery. Surgical treatment was performed in all patients and included bowel resection, followed by sideto-side or end-to-end anastomosis, stoma construction and in some cases abdominal wall reconstruction with prosthesis. Conclusion: Despite significant advances in the management in last decades, bowel fistulas still remain a major clinical problem with serious mortality rate of 15-25 %. Operative treatment is necessary in 35 to 80 % of patients in order to achieve closure.
РЕЗЮМЕ Перитонеалната диализа навлиза широко в клиничната практика като заместител на бъбречната ... more РЕЗЮМЕ Перитонеалната диализа навлиза широко в клиничната практика като заместител на бъбречната функция през 70–години на ХХ век. Установено е, че морталитетът и морбидитетът свързани с диализния достъп са значително по-ниски при перитонеалната, отколкото при хемодиализата. Успехът на перитонеалната диализа се определя от наличието на функциониращ и траен достъп до коремната кухина, което зависи в по-голяма степен от оперативната техника, отколкото от вида на перитонеалния катетър. В настоящето проучване представяме различните видове оперативни техники за поставяне на перитонеални катетри, различните видове катетри, както и да споделим нашия десетгодишен опит при пациенти с ХБН, при които сме поставили перитонеални катетри.
Construction of a stoma is a surgical procedure which is performed in some bowel resections. Alth... more Construction of a stoma is a surgical procedure which is performed in some bowel resections. Although there is a high frequency of these procedures, there is an appreciable complication rate (20-70% of all cases). The most common complications are skin excoriation and irritation, prolapse, retraction, ischemia, parastomal hernia and stenosis. For a 13-year period (May 2001 - May 2013), 478 surgical interventions performed in the Second Department of Surgery were completed with temporarily or permanently colostomy or ileostomy. A total of 86 corrections of a stoma with different complications were performed, but only in 21 of the patients (4,3%) the previous operation was in our Department. The cases were analyzed by age, gender, BMI, form and cause for the first operation, stoma complications and morbidity rate. In the present communication, we share our experience with the treatment of stoma complications.
International Journal of Gastroenterology, 2021
Actinomycosis is an indolent infection that usually presents a diagnostic challenge to the physic... more Actinomycosis is an indolent infection that usually presents a diagnostic challenge to the physician. The most commonly affected zones are the cervicofacial, thoracic and abdominal areas. Abdominal actinomycosis although recognized for more than 150 years, is still wide unknown for most of the clinicians. Its various clinical manifestations are usually considered to present malignant process rather than infection. Intramural gastric actinomycosis is extremely rare clinical noosologic unit and usually the original source of infection is unknown. The usual clinical presentations include mild fever, epi- or mesogastric pain, weight loss, and bleeding from upper gastrointestinal tract. This chronic infection has tends to mimic malignancy. Gastric actinomycosis is very rare and with a good prognosis gastric disease. When established clinically, that is quite difficult diagnosis to be done before obtaining a surgical specimen. Although the findings are nonspecific, actinomycosis should be...
Acute diverticulitis is a disease with a wide clinical spectrum, ranging from a phlegmon (stage I... more Acute diverticulitis is a disease with a wide clinical spectrum, ranging from a phlegmon (stage I a) to localized abscesses (stages I b and II), to free perforation with purulent (stage III) or feculent (stage IV) peritonitis. The planned therapy of colonic diverticulitis is very difficult because preoperative diagnosis is uncommon and the method of treatment is usually decided at the time of laparotomy. While there is a little debate about the best treatment for mild episodes, uncertainty persists about the optimal management for severe episodes and complicated diverticulitis.
Introduction: Neuroendocrine tumors originate from chromaffin-like cells and are tumors with neur... more Introduction: Neuroendocrine tumors originate from chromaffin-like cells and are tumors with neuroendocrine function and malignant potential. In the majority of the cases, they affect the gastrointestinal tract and pancreas. In the diagnosis of primary pancreatic carcinoma, 95% of cases are adenocarcinomas, and the remaining 5% are asymptomatic neuroendocrine tumors.Aim: We report a case of NET of the pancreas localized in processus uncinatus.Results: The patient underwent an enucleation of the tumor. On histological examination: markedly cellular with mostly dispersed tumor cells, also some loose clusters, acinus-like formations, small sheets, rosette-like formations and ribbons. Immunohistological stains were performed with the following results: the epithelial component was positive fоr Synaptophysin(+), Chromogranin(+), CDX2(+), TTF1(-), Ki67<2%. There was a histological demonstration of the well-differentiated neuroendocrine carcinoma of the pancreas. Overall, the patient t...
[EN] Obstructive jaundice is one of the most common problems in surgery. Biliary obstruction is a... more [EN] Obstructive jaundice is one of the most common problems in surgery. Biliary obstruction is a frequent clinical symptom occurring in neoplasms of pancreato-biliary system or metastases of carcinomas with another primary localization. In the last decades there is an increase of the number of patients with cancer causing biliary obstruction. Most of these patients are in a stage that does not allow radical surgical intervention. The decision which procedure to be used for these patients is still controversial. Less trauma inducing and high efficiency of mini-invasive methods of treating malignant diseases complicated by mechanical jaundice, determine the need for comparative evaluation of surgical, endoscopic and X-ray controlled methods of treatment aimed at making them altogether an optimum combination of treatment on advanced level. /////// /////// [BG] Иктерът с обструктивна генеза е един от всекидневните проблеми в съвременната хирургия. Билиарната обструкция е често срещащ се клиничен симптом проявяващ се при неоплазми на панкреатобилиарната система или метастази на карциноми с друга първична локализация. Малката травматичност и високата ефективност на миниинвазивните методи на лечение на злокачествените заболявания, усложнени с механична жълтеница, обуславят необходимостта от сравнителна оценка между хирургичните, ендоскопските и под рентгенологичен контрол методи на лечение, с цел изработването от всички тях на оптимално съчетание на лечение на съвременно ниво.
Introduction : A liver abscess represents capsulated purulent focus in the liver parenchyma, due ... more Introduction : A liver abscess represents capsulated purulent focus in the liver parenchyma, due to bacterial, fungal or parasite invasion. In the recent years their frequency rate related to malignant diseases has increased, including abscesses in liver metastases. Aim : We present four cases of metastatic colorectacal carcinoma, associated with pyogenic liver abscess, which were treated in the Second Department of Surgery, St. Marina University Hospital, Varna. Results : We registered synchronous metastases and in two patients and the remaining two had metachronous metastases. The average age of our patients was 60 years (range 45-80). The patients were operated on and the following interventions were performed – in one - segmentectomy; in two - liver resection with right hemicolectomy; in one - incision, biopsy and drainage; and in one – percutaneous drainage. We established the following systemic complications: pleural effusion in one patient, in one – arrhythmia, subphrenic a...
Scripta Scientifica Medica, Apr 20, 2010
Journal of IMAB - Annual Proceeding (Scientific Papers), 2019