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Acute surgical diseases of an abdominal cavity behind a mask of food toxicoinfection.
LIBRARY OF THE PRACTICAL DOCTOR
ACUTE SURGICAL DISEASES OF THE ABDOMINAL CAVITY BEHIND A MASK OF FOOD TOXICOINFECTION
OSPOVAT BORIS LVOVICH KOPYLKOV ALEXEY IVANOVICH
"Medicine" - Moscow - 1971
The book is devoted to almost important issue about the reasons of the wrong diagnoses which are quite often disappearing under so widespread diagnosis as acute food toxicoinfection. Relevance of a subject is visible already that during the summer period from 1/4 to 1/2 all patients coming to a big hospital the unsophisticated doctor can take for patients with food toxicoinfection. Under this diagnosis both the acute appendicitis, and acute cholecystitis, and the broken extrauterine pregnancy, and the restrained hernia disappears, and intestinal impassability and is a lot of other diseases.
Paying special attention to difficulties and a complexity of a clinical picture in the book that often is the reason of the wrong or overdue diagnosis, authors stop also on errors of medical tactics which in some cases cause the wrong diagnosis. In a number of heads and the main differential diagnostic characters on which the diagnosis is based are given in tables.
Material is stated by the doctors who are working hard years by consultants-surgeons in infectious departments of the Moscow hospital of S. P. Botkin.
The book is intended for the beginning doctors, generally surgeons and infectiologists.
The monograph is devoted to recognition of acute surgical diseases of an abdominal cavity and their differential diagnosis with a food toksikoiifektion. The subject elected by authors is extremely actual; it concerns daily, most crucial work of the practical doctor. To light it, to authors it is necessary not only experience of the surgeon, but also sufficient erudition in bordering limits, in particular in infectious diseases. The monograph reflects wide personal experience of authors, is saturated with the important practical advice necessary for the young doctors giving acute management to patients with acute diseases of an abdominal cavity.
A small amount of works in which generally raise tightly special questions of clinical diagnosis is devoted to a question of the wrong diagnosis of food toxicoinfection in clinic of an urgent surgery and almost the attention is not paid to wrong medical tactics.
The diagnosis of acute food intoxication is artful; he is treated by patients with an acute appendicitis, cholecystitis, pancreatitis, an extrauterine pregnancy, inflammatory gynecologic diseases, the intestinal impassability restrained by hernia and other acute diseases of an abdominal cavity.
The wrong and overdue diagnosis quite often depends on insufficient acquaintance of the surgeon to features of the illness called by acute food toxicoinfection, and the infectiologist — with consecutive, methodologically correct research of the patient at which suspect an acute disease of an abdominal cavity.
At the beginning of the monograph the salmonellosis problem is considered. The special attention is deserved by the section on similarity and distinction of some major symptoms at acute surgical diseases of an abdominal cavity and food toxicoinfection. Authors emphasize need of critical perception of identical symptoms: pains, vomiting, a diarrhea, the muscular tension of an abdominal wall, a blood picture etc., paying tribute to well collected anamnesis and detailed survey of the patient. They pay attention that it is necessary to consider those nuances in an illness picture which sometimes have bigger value, than the standard "book" symptoms.
In the second part of the monograph the differential diagnosis between individual surgical diseases of an abdominal cavity and acute food toxicoinfection is stated. In chapter about appenditsita of special attention the question of an inflammation of abnormally located worm-shaped shoot deserves. Huge practical value of this question is visible at least that 76% of a lethality of an acute appendicitis are the share of retrocecal and pelvic appenditsita.
In the section devoted to the differential diagnosis between acute cholecystitis and food toxicoinfection, authors fairly specify that degree of manifestation of symptoms at acute cholecystitis differs in a big variety depending on an illness form, especially at destructive cholecystitis when on the foreground intoxication phenomena act. The section devoted to the differential diagnosis between food toxicoinfection and intestinal impassability at which mistakes and omissions are most frequent is of great practical interest.
Accurately analyzing diagnostic mistakes and the wrong tactics on numerous striking and convincing examples, authors quite appropriate quote Raug that "symptoms should be not considered, they should be weighed".
On completeness of coverage of questions of differential diagnosis and detail of their development the monograph exceeds the works devoted to this subject.
The conclusions of authors based on long-term practical work in close contact with infectiologists deserve an appreciation. It is a result of long-term supervision and thoughts.
The monograph, certainly, will be the useful and necessary book for the practical doctor, valuable addition to necessary medical desktop grants.
Honored worker of science prof. B. S. Rose trees