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Traumatic Hemoperitoneum: diagnostic, therapeutic and evolutions aspects


Author: Aneste Eduard
Degree:doctor of medicine
Speciality: 14.00.27 - Surgery
Year:2020
Scientific adviser: Gheorghe Rojnoveanu
doctor habilitat, professor, Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova
Scientific consultant: Olga Tagadiuc
doctor habilitat, associate professor (docent)
Institution: Nicolae Testemitanu State University of Medicine and Pharmacy of the Republic of Moldova

Status

The thesis was presented on the 6 February, 2020
Approved by NCAA on the 28 February, 2020

Abstract

Adobe PDF document0.34 Mb / in romanian

Thesis

CZU 616.381-001.31-005.1-089

Adobe PDF document 13.83 Mb / in romanian
187 pages


Keywords

blunt abdominal trauma, traumatic hemoperitoneum, non-operative treatment

Summary

The thesis consists of introduction, 5 chapters, general conclusions, bibliography of 277 titles, 5 annexes. The thesis is illustrated by 10 tables, 43 figures and 113 pages of basic text. The results obtained are published in 24 scientific papers.

Field of study: surgery - 321.13. Aim of the study: clinical and paraclinical reasoning of the harmlessness of posttraumatic hemoperitoneum during absorption in blunt abdominal parenchymal organs trauma patients with non-operative management.

Objectives of the study: literature study on the particularities of the trauma patients with hemoperitoneum and the pathophysiological and clinical changes of blood evolution in the peritoneal cavity; experimental assessment of the local intraperitoneal and systemic consequences of post-traumatic hemoperitoneum; analysis of clinical and paraclinical evolutive changes of hemoperitoneum in trauma patients with blunt abdominal trauma and nonoperative management; objectively justifying the safety of intraperitoneal blood absorption by analyzing local and systemic changes in experimental and clinical study through imagistic and laboratory.

Scientific novelty of the paper: it has been shown that, there are no significant statistical differences according to the biochemical parameters during evolution of post-traumatic hemoperitoneum unconcerned the severity of the parenchymal organs injury and the associated hemoperitoneum volume.

The scientific problem solved in the thesis: resides in the scientific confirmation of the hemoperitoneum's safety in an experimental and clinical model, which confirmed the opportunity of conservative approach in patients with blunt abdominal trauma and severe spleen and liver trauma with associated hemoperitoneum and allows optimizing their management.

Theoretical importance and applicative value of the work: The research analyzed the role of post-traumatic hemoperitoneum in the evolution of patients with blunt abdominal trauma, which allowed optimizing their management by indicating non-operative treatment to those with hemoperitoneum secondary to IIIIV lesion degree according to AAST classification.

Implementation of the scientific results: the results of the study are applied in the practice of the „Nicolae Anestiadi” Department of Surgery no.1 of the State University of Medicine and Pharmacy „Nicolae Testemitanu” at the Institute of Urgent Medicine.