Acute mesenteric ischemia is a group of conditions characterized by an acute impairment of intestinal blood supply, resulting in critical ischemia and necrosis of the affected bowel segments. Purpose of the study . To analyze the diagnostic and treatment outcomes of patients with acute mesenteric ischemia in a multidisciplinary hospital and to evaluate the outcomes of surgical treatment strategies incorporating endovascular techniques. Patients and methods. A retrospective analysis was performed of the diagnostic and treatment outcomes of 73 patients admitted to a multidisciplinary hospital between 2021 and 2023. The study included 50 (68.49 %) women and 23 (31.51 %) men. The mean age of the patients was 75.3 ± 9.05 years. The time from the onset of the first symptoms to transport by ambulance and hospital admission was up to 6 h in 23 patients (31.5 %), 6–24 h in 20 patients (27.4 %), and more than 24 h in 30 patients (41.1 %). Depending on the diagnostic and treatment strategy used, the patients were divided into five groups. Results. The overall mortality rate in the study cohort was 69.86 %. Mortality rates varied according to the diagnostic and treatment strategy. The lowest mortality rate was observed in the group receiving endovascular treatment alone (44.4 %). Mortality was 54.55 % in the group undergoing combined endovascular and open surgical treatment, 71.4 % in the group undergoing surgical treatment alone, 100 % in the group undergoing combined open vascular and surgical interventions, and 100 % in the group receiving conservative treatment. Conclusion. Rapid transport of patients with acute mesenteric ischemia to a multidisciplinary hospital and timely CT angiography improve diagnostic accuracy, shorten the time to diagnosis, facilitate the selection of an appropriate treatment strategy, and reduce the risk of adverse outcomes. The use of endovascular techniques to restore mesenteric vessel patency as part of the comprehensive treatment of acute mesenteric ischemia reduces mortality.
Purpose of the study . To analyze the literature on the use of indocyanine green in medicine. Materials and methods . A literature review was conducted using the PubMed, Google Scholar, and eLibrary databases, covering the period from 1995 to 2026. Results . Indocyanine green (ICG) is a water-soluble fluorescent dye developed in the mid‑20th century and approved for clinical use in the late 1950s. It is now widely used in various fields of medicine. In oncology, ICG is used for sentinel lymph node mapping to facilitate the detection of metastatic spread. In reconstructive and plastic surgery, intraoperative assessment with ICG reduces the risk of complications associated with autologous and implant-based reconstruction by enabling the identification of poorly perfused tissue and thereby reducing the incidence of tissue necrosis. In ophthalmology, ICG enables visualization and assessment of the fundus vasculature, particularly the choroidal circulation, in various ocular diseases. In cardiology and cardiac surgery, ICG is used to determine cardiac output and to assess anastomoses and coronary artery bypass grafts. In neurosurgery, ICG is used to visualize vascular structures, assess tissue perfusion and tumor margins, and assist in peripheral nerve reconstruction. In abdominal surgery, ICG facilitates assessment of anastomotic perfusion and visualization of tumor resection margins, thereby reducing the risk of postoperative complications, and may aid in the detection and differentiation of liver metastases. Conclusion . Indocyanine green is a versatile agent used for both intraoperative navigation and the assessment of surgical treatment outcomes. Advances in diagnostic and imaging technologies continue to create new opportunities for expanding the clinical applications of this method.
Purpose of the study . To perform a morphofunctional assessment of the pancreas following administration of a combination of semaglutide + omeprazole + gamma-aminobutyric acid in a db/db mouse model of type 2 diabetes mellitus. Materials and methods . The experiment was conducted in 16‑week-old male db/db (C57BL/KsJ-Leprdbtb) mice (n = 192), which received the following agents orally every day for 90 days: A – semaglutide, B – omeprazole, and C – gamma-aminobutyric acid. The animals were divided into eight groups: group 1 (n = 26) – diabetic control; group 2 (n = 26) – A + B + C combination; group 3 (n = 26) – A + B combination; group 4 (n = 26) – agent C; group 5 (n = 10) – C57Bl/6 mice; groups 6, 7, and 8 (n = 26 in each group) – intact animals receiving A + B + C, A + B, and C, respectively. Animals were euthanized on days 30 and 90 of the experiment. Results . Group 1 exhibited disruption of pancreatic histoarchitecture characteristic of type 2 diabetes mellitus, accompanied by increased levels of insulin (1.5‑fold), HbA1c (1.3‑fold), C-peptide (3.9‑fold), leptin (1.4‑fold), total cholesterol (1.1‑fold), and triglycerides (1.2‑fold), as well as a 2.3‑fold decrease in adiponectin levels. Results were considered statistically significant at p < 0.05. In group 2, administration of the A + B + C combination was associated with less pronounced pancreatic damage compared with all other groups. Conclusion. Morphofunctional assessment demonstrated restoration of pancreatic histoarchitecture following administration of the A + B + C combination, supporting the β-cell cytoprotective effect of this therapy. Keywords: type 2 diabetes mellitus, semaglutide, omeprazole, gamma-aminobutyric acid, pancreatic islets> < 0.05. In group 2, administration of the A + B + C combination was associated with less pronounced pancreatic damage compared with all other groups. Conclusion . Morphofunctional assessment demonstrated restoration of pancreatic histoarchitecture following administration of the A + B + C combination, supporting the β-cell cytoprotective effect of this therapy.
Combat trauma to major limb vessels remains a pressing issue in military field surgery, often leading to disability in patients of working age. The formation of false aneurysms is a characteristic but not always obvious complication of shrapnel wounds, particularly in the absence of a tourniquet and with preserved distal blood flow. To present a clinical case of the incidental diagnosis and successful surgical treatment of a false aneurysm of the radial artery in a service member with combined shrapnel wounds to the forearm and thigh. A 39‑year-old male patient was admitted to a forward medical unit 2 days after sustaining shrapnel wounds to the right forearm and right thigh. Upon admission, he complained of pain in the wound areas. The primary clinical finding was an extensive subcutaneous hematoma of the forearm extending to the lower third of the arm. A pulsatile mass, 3 cm in diameter, was detected upon palpation only during a targeted examination. Ultrasound angioscanning (USAS) revealed a false aneurysm of the radial artery with a volume of 10 mL. Surgical intervention was performed: resection of the aneurysm and repair of the arterial wall with a lateral suture. The thigh wound was managed concurrently. Intraoperatively, a 3 mm defect in the arterial wall was confirmed. Blood flow through the main arteries of the forearm was fully restored. The postoperative period was uneventful. The patient was evacuated to the next level of specialized care on the third postoperative day with satisfactory blood flow and complete restoration of active movements. This case highlights the importance of maintaining a high index of suspicion for vascular pathology in all patients with mine-blast and shrapnel injuries, even in the absence of classic signs of acute ischemia or bleeding. Early use of USAS enables timely diagnosis of false aneurysms and allows for limb-saving surgery, thereby preventing patient disability.
Purpose of the study . To investigate the morphological features of induced An3Ca endometrioid carcinoma and visceral organs in BALB/c nude mice under conditions of diabetes mellitus. Materials and methods . Female BALB/c nude mice weighing 25 ± 2.5 g were used to model uterine tumor growth under conditions of diabetes mellitus. The animals were divided into two experimental groups: group 1 (control) – intrauterine growth of endometrioid carcinoma (n = 5); group 2 (study group) – intrauterine growth of endometrioid carcinoma in the presence of diabetes mellitus (n = 5). Sections of the tumor nodules and organs (uterus, ovaries, liver, lungs, thyroid gland, adrenal glands, and pancreas) were examined microscopically, with images captured using a digital camera. Results . Tumor growth without alloxan administration resulted in the formation of a single tumor nodule in the right uterine horn, with preservation of the main morphological features of its architecture. In contrast, alloxan administration was associated with the formation of a tumor consisting of several separate nodules that completely obliterated the structure of the right ovary and replaced it with tumor tissue. Metastatic involvement of the liver accompanied by vascular congestion of the parenchyma was observed. In the lungs, destruction of the alveolar and bronchial structures was accompanied by vascular congestion, foci of hemorrhage, mucus accumulation in the airway lumens, and the presence of tumor cells. Marked thickening of the colloid was observed throughout the thyroid follicles. Involutional changes were noted in the X-zone and zona glomerulosa of the adrenal cortex, with focal expansion of the zona fasciculata. Diabetes modeling resulted in almost complete loss of the exocrine pancreatic parenchyma, exposing the stromal framework of the organ. Its morphological identity could be established only from isolated small areas of degeneratively altered acini and rare remnants of the islets of Langerhans. Conclusion . In the experimental bimodal model combining two pathological processes, cancer and diabetes mellitus, morphological evidence of mutually reinforcing mechanisms of adverse systemic effects involving multiple organs was observed. This pronounced synergistic effect was manifested by stimulation of tumor progression and pathological changes in visceral organs, expanding our understanding of cancer pathogenesis in the presence of comorbid disease.
