Djanelidze Research Institute of Emergency Medicine abdominal cavity

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                               INTERIM EPICRISIS #
Patient __52 years old______________________ has been treated in the hospital for the period
             (full name and age)
starting from July 03, 2008 until the present moment in the department of
(department name)

As a result of patient examination the following diagnosis was set:
Principal: stomach cancer T4N3M1
Complications: pain syndrome

The following treatment was rendered in the department:

1. Operation, 08-July-2008. Explorative laparotomy.
Under endotracheal anesthesia the incision “mersedes”-type of the abdominal cavity was made
layer-by-layer. In all sections the ascitic fluid was up to 200 ml. At revision a growth of the
stomach body was revealed; it goes by the lesser curvature of stomach; size: 10*8 cm; invasion
into the celiac trunk. Plural metastases in paraaortic glands, in lesser omentum and caul, in
mesocolon; carcinomatosis of peritoneum. No metastasis in the liver. The patience of the passage
of stomachic content is not disturbed. Histologically undifferentiated cancer. The case is
incurable. A PVC tube in subhepatic area. Layer-by-layer suture. Aseptic dressing.
2. 08-July-2008. Thoracoscopiс splanchnikectomy on the right.
Under endotracheal anesthesia right-side pneumatothorax was applied. Manipulate trocars were
introduced. In the inferior lobe of the left lung a new growth is visualized; suspected metastasis;
diameter up to 1 cm. Hydrothorax up to 50 ml. Right-side splanchnikectomy is performed with
technical complications. The pleural cavity is drained by the Bulau method. Sutures. Aseptic
3. 16-July-2008. Intra-abdominal port for intraperitoneal chemotherapy.

2. Conservative treatment: diet 0-1, day regimen #1-2
Infusion chemotherapy: polarizing mixture, spasmolytics, cardiotonic agents, NSAICh
(nonsteroidal anti-inflammatory chemicals), Trental, Actovegin, analgetics, Perfalgan, Atarax,
Antibacterial: Metrogil, Ciprofloxacin
Hemo-pasmotransfusion: - 2D SZP

Blood group: A(2)
Rh-factor: (+) pos.

Pathological histological conclusion, d/d 26-June-2008 #9882-85: Undifferentiated cancer
X-ray examination, d/d 15-July-2008: the lung pattern is intensive and thick in the core zone and
in basal arrears from both sides. Cancerous lymphangiitis?
EKG, d/d 03-July-2008: Sinus rhythm. Load on the left atrium. Incomplete blockade of the right
crus of His' bundle.


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