АLGORITHM OF RADIATION EXAMINATION OF HIVINFECTED PATIENTS WITH ACUTE STOMACH SYNDROME

Abstract

The purpose of the work: development and generalization of the algorithm of radiation examination of HIV-infected patients with acute abdominal syndrome. Materials and methods. The work is based on the results of examination of 92 patients who were on treatment in the surgical department for the period from 2010 to 2017. The specificity and sensitivity of ultrasound diagnostics, radiography, contrast methods and magneto-contrast methods were evaluated. Results. To improve the methods of rendering specialized medical care to HIV-infected patients entering the clinic of an acute abdomen, it is advisable to use the syndromic approach, which provides for the allocation of syndromes of acute intestinal obstruction, a widespread inflammatory process of the abdominal cavity, a limited inflammatory process of the abdominal cavity and perforation syndrome of the hollow organ. Diagnostic possibilities of the survey radiography and ultrasound of the abdominal organs in these patients are limited due to hyperpneumatization of the intestine and the presence of free fluid in the abdominal cavity. Contrast study of the gastrointestinal tract (passage of barium) is contraindicated in case of suspected perforation of the hollow organ, which often occurs in this category of patients. Multispiral computed tomography is the method of choice for examining HIV-infected patients with acute abdominal syndrome, because it allows, and quickly, to answer many tactical questions, provides the possibility of performing therapeutic manipulations under CT control (percutaneous aspiration of pathological fluid accumulations, drainage of abscesses, establishment nephro-, cholecysto-, cholangiostom). The use of the method of magnetic resonance imaging is limited because of the severe condition of patients and is applicable for assessing the effectiveness of the therapy for liver abscesses, diagnosis of heart attacks and abscesses of the spleen, development and description of the survey algorithm.