THE LITTLE KNOWN DOMESTIC APPENDICULAR PALPATORY DIAGNOSTIC TECHNIQUES IN ADULTS: THEIR EFFECTIVENESS AND PRACTICAL SIGNIFICANCE AT THE PREHOSPITAL STAGE
https://doi.org/10.17238/issn2072-3180.2021.1.10-15
Abstract
Objective: To exchange clinical experience between surgeons, namely, private methods of physical examination of adult patients with acute appendicitis.
Material and methods. Between January 2017 and December 2020, the sample included 300 patients aged 18–55 years (average age was 36.4±3.2 years), without gender. The study included two stages: pre-hospital (assessment of symptoms by paramedics and doctors of linear teams of ambulances, doctors of primary (polyclinic) level) and hospital (assessment of symptoms by surgeons of the hospital's emergency Department with subsequent comparative verification by laboratory and instrumental, including intraoperative diagnostics). In total, the study included 20 paramedics and 5 doctors of linear emergency medical teams and 5 doctors of polyclinics in Volgograd and 15 surgeons of emergency departments.
Results. During the performed study was to obtain results that indicate sufficient validity of the studied prehospital appendicular symptoms, which allows to conclude the following: the symptom is R. V. Soft was accurate in 87%, and symptom I. Krayushkina in 86% of cases of destructive forms of acute appendicitis.
Conclusion. These appendicular symptoms can be recommended for use in routine clinical practice, both at the prehospital and hospital stages of diagnosis of acute appendicitis in adults.
About the Authors
S. I. Krayushkin
Volgograd state medical University, Ministry of health of Russia
Russian Federation
Russian Federation
Sergey I. Krayushkin — Prof., MD, head of the Department of outpatient and emergency medical care
400131, Volgograd, Fallen fighters square, 1
R. V. Myakonkiy
Volgograd regional clinical hospital No.3
Russian Federation
Russian Federation
Roman V. Myakonkiy — surgeon of the surgical Department
400001, Volgograd, Tsiolkovsky str., 1
K. O. Kaplunov
Volgograd state medical University, Ministry of health of Russia
Russian Federation
Russian Federation
Kirill O. Kaplunov — PhD in Medicine, associate Professor of the Department of Pediatrics and neonatology, Institute of continuing medical and pharmaceutical education
400131, Volgograd, 1 Fallen fighters square
References
1. Bykov A.V., Mjakon’kij R.V., Petrov A.V., Pankratov A.I. Appendjektomija kak prediktor professionalizacii nachinajushhego hirurga v uslovijah jekstrennoj hirurgii [Appendectomy as a predictor of professionalization of a novice surgeon in emergency surgery]. Al’manah Instituta hirurgii im. A.V. Vishnevskogo, 2017, No. 3, pp.132–136. (In Russ.)
2. Ivanchenko A.Ju., Kaplunov K.O. Simptom R.V. Mjakon’kogo — novyj opornyj simptom v diagnostike ostrogo appendicita [Symptom R.V. Myakonkogo — supporting a new symptom in the diagnosis of acute appendicitis]. Sb. materialov II s#ezd hirurgov Privolzhskogo federal’nogo okruga s mezhdunarodnym uchastiem. Pod. red. prof. M.V. Kukosha i V.V. Parshikova. Nizhnij Novgorod, 2018, pp. 149-154. (In Russ.)
3. Mjakon’kij R.V. Professional’noe stanovlenie nachinajushhego hirurga. Problemy i reshenija [Professional development of a novice surgeon. Problems and solutions]. Saarbrucken: LAP LAMBERT, 2019, 207 p. (In Russ.)
4. Mjakon’kij R.V. Professional’noe stanovlenie nachinajushhego hirurga v aspektah andragogiki i sociologii mediciny [Professional development of a novice surgeon in the aspect of andragogy and sociology of medicine]. Saarbrucken: LAP LAMBERT, 2020, 202 p. (In Russ.)
5. Mjakon’kij R.V. Professional’noe stanovlenie nachinajushhego hirurga v aspektah andragogiki i sociologii mediciny [Professional development of a novice surgeon in the aspect of andragogy and sociology of medicine]. M.: Izdvo NIC MISI, 2020, 200 p. (In Russ.)
6. Mjakon’kij R.V., Ivanchenko A.Ju. Appendikuljarnaja trojka [Appendicular triplet]. Sb. materialov II s#ezd hirurgov Privolzhskogo federal’nogo okruga s mezhdunarodnym uchastiem. Pod. red. prof. M.V. Kukosha i V.V. Parshikova. Nizhnij Novgorod, 2018, pp. 159–164. (In Russ.)
7. Mjakon’kij R.V., Ivanchenko A.Ju. Novyj opornyj simptom pri ostrom appendicite u vzroslyh [New reference symptom for acute appendicitis in adults]. Sb. materialov Aktual’nye problemy jeksperimental’noj i klinicheskoj mediciny materialy 76-j mezhdunarodnoj nauchno-prakticheskoj konferencii molodyh uchenyh i studentov, 2018, p. 130. (In Russ.)
8. Mjakon’kij R.V., Ivanchenko S.V., Ivanchenko A.Ju., Kaplunov K.O. Novyj opornyj simptom pri ostrom appendicite u vzroslyh [New reference symptom for acute appendicitis in adults]. Vestnik Dagestanskoj gosudarstvennoj medicinskoj akademii (Prilozhenie), 2018, No. 2 (27), p. 212. (In Russ.)
9. Mjakon’kij R.V., Kaplunov K.O. Monoligaturno-invaginacionnyj pogruzhnoj sposob obrabotki kul’ti cherveobraznogo otrostka pri tradicionnoj appendjektomii v uslovijah pandemii COVID-19 [Monoligatureinvagination submerged method of treatment of the stump of the Appendix during traditional appendectomy in the conditions of the COVID-19 pandemic]. Vestnik Bashkirskogo gosudarstvennogo medicinskogo universiteta, 2020, No. 3, (setevoe izdanie), p. 25– 31. (In Russ.)
10. Mjakon’kij R.V., Kaplunov K.O., Ivanchenko A.Ju., Pankratov A.I., Ivanchenko S.V. Novyj bolevoj sindrom v fizikal’noj diagnostike ostrogo appendicita [New pain syndrome in the physical diagnosis of acute appendicitis]. Rossijskij zhurnal boli (Special’nyj vypusk), 2019, No. 17, p.117. (In Russ.)
11. Mjakon’kij R.V., Krajushkin S.I. Kljuchevye momenty dogospital’noj diagnostiki ostrogo appendicita [Key points of prehospital diagnosis of acute appendicitis]. l’manah Instituta hirurgii im. A.V. Vishnevskogo, 2019, No. 2, pp. 10–11. (In Russ.)
12. Mjakon’kij R.V., Krajushkin S.I., Bykov A.V. Poljancev A.A. Validacija novyh pal’patornyh appendikuljapnyh diagnosticheskih tehnik pri abdominal’nom sindrome u vzroslyh [Validation of new palpatory appendicular diagnostic techniques for abdominal syndrome in adults]. Rossijskij zhurnal boli. (Special’nyj vypusk), 2020, No. 18, pp. 89–90. (In Russ.)
13. Krajushkin S.I., Mjakon’kij R.V., Krajushkin S.S., Kolesnikova I.Ju., Zaporoshhenko A.V. Validacija pal’patornyh tehnik diagnostiki ostrogo appendicita u vzroslyh na dogospital’nom jetape [Validation of palpatory techniques for diagnosing acute appendicitis in adults at the prehospital stage]. Al’manah Instituta hirurgii im. A.V. Vishnevskogo, 2020, No. 1, pp. 812–814. (In Russ.)
14. Rukovodstvo po neotlozhnoj hirurgii organov brjushnoj polosti: Rukovodstvo dlja vrachej. [Manual of Emergency Abdominal Surgery: A guide for doctors]. Pod. red akad. RAN i RAMN V.S. Savel’eva; red.-sostaviteli akad. RAMN A.I. Kirienko. – 2-u izd., ispr. i dop. M. : OOO «Izdatel’stvo «Medicinskoe informacionnoe agentstvo», 2014, 544 p. (In Russ.)
15. Myakonky R.V., Sedova N.N., Navrotsky B.A., Reymer M.V. Ethics of mentoring in surgery (From the Experience of Modern Russian Medicine). Medicine and Law. World Association for Medical Law. Haifa, 2020, No. 39, 3, pp. 447–462. (In Russ.).
Review
For citations:
Krayushkin S.I., Myakonkiy R.V., Kaplunov K.O. THE LITTLE KNOWN DOMESTIC APPENDICULAR PALPATORY DIAGNOSTIC TECHNIQUES IN ADULTS: THEIR EFFECTIVENESS AND PRACTICAL SIGNIFICANCE AT THE PREHOSPITAL STAGE. Moscow Surgical Journal. 2021;(1):10-15. (In Russ.) https://doi.org/10.17238/issn2072-3180.2021.1.10-15
Views:
475
Email this article 