Features of pathogenesis, clinical course and diagnosis of acute cholecystitis of patients with decompensated cardiovascular diseases
The work presents the features of pathogenesis, clinical course and diagnosis of acute cholecystitis of patients with decompensated cardiovascular diseases have been submitted in this report. The main diseases of cardiovascular system that affects the prognosis of acute cholecystitis have been set off. The sufficient detailed is written about the criteria for patients at risk. Listed severe somatic diseases, which are frequent in older patients being treated in surgical hospitals. The pathogenetic link between inflammatory disease of the gallbladder and cardiovascular system has been explained. The problem of mutual deterioration between acute cholecystitis and different manifestations of coronary artery disease has been reviewed. The noting widespread introduction of new non-invasive methods (ultrasonography, computer tomography and magnetic resonance tomography) and invasive (endovideosurgery) diagnostics. Detailed characteristics of such instrumental techniques as ultrasonography, magnetic resonance cholangiopancreatography, magnetic tomography, endoscopic retrograde cholangiopancreatography, diagnostic laparoscopy has been given. The role of specific biochemical markers of necrosis has been showed: creatinephosphokinase, its heart fraction, troponin test. Possible changes on the electrocardiogram of patients with acute cholecystitis and reasons for their appearance have been described. Detailed recommendations for the identification of acute myocardial infarction of patients with acute cholecystitis using markers of myocardial damage have been given.