Yuriy Khorkavyi
@meduniv.lvi.ua
Surgery #2
Danylo Halytsky Lviv National Medical University
RESEARCH, TEACHING, or OTHER INTERESTS
Health Professions
Scopus Publications
Scopus Publications
Ihor I. Kobza, Yuriy H. Orel, Hlib Y. Orel, Yuliya S. Mota, Taras I. Kobza, and Yuriy Z. Khorkavyi
Professional Edition Eastern Europe
Introduction. Isolated superior mesenteric artery dissection (ISMAD) is a rare disease with high variability of clinical manifestations: from incidental findings to the development of acute or chronic mesenteric ischemia and the formation of aneurysms with the probability of their rupture. Despite significant world experience, surgical and conservative treatment of patients with ISMAD remains debatable.
 The aim. Improvement of the diagnosis and surgical treatment of patients with ISMAD.
 Clinical cases.
 In the first clinical observation, a 78-year-old patient with chronic visceral ischemia was diagnosed with an aneurysm of the upper mesenteric artery with signs of dissection and malperfusion. Previous unsuccessful attempts of endovascular treatment at another hospital caused the need for open surgical intervention – resection of the aneurysm and upper mesenteric artery reconstruction.
 
 In the second clinical case, a 61-year-old patient had acute abdominal pain syndrome, and based on clinical examination, laboratory and instrumental examination, the diagnosis of acute mesenteric ischemia with signs of dissection of the superior mesenteric artery was confirmed, which determined immediate indications for surgical treatment – resection of the affected segment of superior mesenteric artery and aorta-superior mesenteric bypass.
 
 The surgical interventions contributed to complete regression of clinical symptoms. Follow-up of the patients showed promising long-term results.
 
 Conclusion. Computed tomography angiography is the method of choice in the diagnosis of ISMAD and makes it possible to provide prompt diagnosis, determine treatment tactics and prevent the development of fatal complications. Open surgical intervention in some cases remains the method of choice in the treatment of ISMAD.
Yuriy H. Orel, Hlib Y. Orel, Yuriy Z. Khorkavyi, and Oleg M. Slabyy
Professional Edition Eastern Europe
Despite the insigniϐicant prevalence, aneurysms of the splenicartery take a dominant share among all visceral aneurysms with a predominance of morbidity in women of childbearing age. Taking into account the mostly asymptomatic course and the high risk of mortality due to its rupture, timely diagnosis and correct treatment strategy remain extremely important. Questions regarding the choice of surgical treatment tactics for patients with this pathology remain debatable.
 The aim. Demonstration of a clinical case, improvement of diagnosis andsurgical treatment of patients with splenic artery aneurysms.
 Clinical case. Female patient G., 32 years old, with complaints of periodic pain in the left hypochondrium, signs of portal hypertension against the background of cavernous transformationof the portal vein, history of recurrent bleeding from the esophageal veins, hypersplenism admitted with a pre-diagnosed aneurysm of the splenic artery of giant dimensions (diameter 8x5 cm). The patient was qualified for open surgery and aneurysm resection with splenectomy and spleen autotransplantation by N. Roth. The postoperative period was complicated by the occurrence of reactive pancreatitis on day 7, which was successfully treated conservatively. In the future, the course was unremarkable. The remote follow-up lasted two years, and no recurrence of the aneurysm was detected. The performed immunogram showed normal results.
 Conclusion. The timely diagnosis makes it possible to establish the correct diagnosis, justify the treatment tactics and prevent fatal complications. Open surgical intervention in somecases remains the method of choice in the treatment of this pathology. Autotransplantation of the spleen has shown good long-term results and can be performed in patients of this category for the prevention of immunodeficiency states.
Yulian Konechnyi, Yurii Khorkavyi, Kateryna Ivanchuk, Ihor Kobza, Alicja Sękowska, and Olena Korniychuk
Wiley
AbstractVibrio metschnikovii is a widespread opportunistic pathogen that rarely causes disease in human. It caused graft infection in our case. It is important to differentiate it from another water‐transmitted pathogens.