EXPERIENCE OF DIAGNOSTICS AND TREAT-MENT OF GENUINE AND FALSE (BROCK’S) STRANGULATION OF THE ABDOMINAL HENIA

The results of diagnostics and algorithm of treatment of patients with genuine and three patients with a false strangulation (Brock's) of the abdominal hernia. The purpose of the work. To study the results of di-agnosis and therapeutic tactics with true and false strangulation of the anterior abdominal hernia. Discussion and results. Patients (112) with strangu-lated hernias were operated by plastic hernia gates of their own tissues 68 (60.7%), and 44 (39.3%) - polypropylene mesh. The Brock's false strangulation was in three patients, male, aged 27 to 57, with localization of hernia: inguinal-1, umbilical-2. In the postoperative period, with the use of a mesh implant the emer-gence of hypodermic fatty tissue and suppuration of the wound were observed in 3 (6.8%), and in classical plastic, such compli-cations arose in 8 (11.7%), which complex treatment was elimi-nated. Diagnostic and therapeutic tactics with Brock's hernia and mistakes are presented in individual cases. The first clinical case demonstrated the emergence of Brock's hernia at acute appendi-citis, clinical signs of which were preceded by a false strangula-tion of the inguinal hernia. In the second case, the cause was a tuberculous peritonitis, which the patient under various diagnoses was treated ambulatory and permanently during the year. The cause of the third case was a chronic abscess between the intes-tinal loops on the background of the previous two month perfo-ration of the small intestine with the fish bone when eating soup. The clinical picture allowed to diagnose the strangulated hernia, but at the same time it was determined by the symptom of "cough shock", and there were no signs of acute intestinal obstruction. Operational findings indicated an acute surgical pathology of the abdominal organs, the signs of which, with careful analysis of each case, preceded the blocking of Brock. Conclusions. 1. In patients with strangulate hernias of the anterior abdominal wall with signs of serous local peritonitis; it is necessary to use allotransplants to close large hernial gates with adequate complex therapy in the postoperative period. 2. In order to prevent fatal errors in the diagnosis and surgical treatment of pseudo-strangulation of hernias (Brock's), it is necessary to carry out a detailed analysis of the evolution of the symptoms of strangulation, and in the audit of hernia content demonstrating another acute pathology of the abdominal cavity, perform an algorithm of thorough intraoperative examination, elimination of the disease with its drainage and a plastic hernia gate.