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
ENDOVIDEOSURGERY.
(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
dressings.
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,
Fenazepam.
Antibacterial: Metrogil, Ciprofloxacin
(chemicals)
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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