The possibilities of cytoreductive operations in recurrent abdominal pain syndrome in cancer patients, occurring under the mask of acute pancreatitis

Among the diseases of urgent pathology, the leading place belongs to acute pancreatitis, which is inferior to such nosologies as acute appendicitis and acute cholecystitis. Moreover, the lion’s share is occupied by light forms, which make up 85%. The aim of the work is to demonstrate a clinical case of recurrent abdominal syndrome occurring under the mask of acute pancreatitis in a patient with oncopathology identified using a diagnostic algorithm used in outpatient practice. Material and methods. Patient F., 60 years old, repeatedly sought medical help in a network of polyclinics and hospitals providing emergency specialized medical care with recurrent abdominal syndrome. Results and discussion. Against the background of conservative treatment, the patient had a short-term positive dynamics characteristic of a mild form of acute pancreatitis. After taking the patient to the dispensary and conducting an in-depth diagnostic examination according to the algorithm developed by our group of researchers, cancer of the stomach stump T2N0M0 was detected. Conclusion. Patients with recurrent abdominal pain syndrome need dispensary observation on an outpatient basis to identify other pathology occurring under the guise of acute pancreatitis and to conduct adequate treatment.

1. Demographic Yearbook of Russia 2017: statistical collection. Moscow. Rosstat. 2017. (In Russian) URL: https://gks.ru/free_doc/doc_2017/demo17.pdf

2. Sabgaida T.P., Ivanova A.E., Zemlyanova E.V. Premature mortality and risk factors as indicators of mortality reduction programs in Russia. Social aspects of public health [Electronic scientific journal]. 2017;3(55). (In Russian)]. URL: http://vestnik.mednet.ru/content/view/831/30/

3. Imaeva A.K., Mustafin T.I., Polovinkina S.R. Morbidity and mortality rates in acute pancreatitis as an indicator of the state of medical care at the regional level. Problems of social hygiene, health care and the history of medicine. 2020;28(6):1298–1303. (In Russian) URL: https://cyberleninka.ru/article/n/pokazateli-zabolevaemosti-i-smertnosti-pri-ostrom-pankreatite-kak-indikator-sostoyaniya-meditsinskoy-pomoschi-na-regionalnom-urovne

4. Ermolaev V.A., Savelyev V.V. Diseases of the pancreas as one of the leading problems of abdominal surgery. In the collection: Postgraduate readings-2021. Collection of materials of the scientific and practical conference of NEFU graduate students. Yakutsk, 2021:66–70. (In Russian).

5. Manukovsky V.A., Barsukova I.M., Dubikaitis P.A. Information materials on emergency surgical care for acute surgical diseases of the abdominal cavity in St. Petersburg for 2021. St. Petersburg. 2022. (In Russian) URL: https://elibrary.ru/item.asp?id=48125100

6. Revishvili A.Sh., Fedorov A.V., Sazhin V.P., Olovyanny V.E., The state of emergency surgical care in the Russian Federation. Surgery. The magazine named after N.I. Pirogov. 2019;3:88–97. (In Russian)

7. Revishvili A.Sh., Kubyshkin V.A., Zatevakhi I.I., Bagnenko S.F., Polushin Yu.S., Maistrenko N.A., Karmazanovsky G.G., Petrikov S.S., Khatkov I.E., Shabunin A.V., Bagnenko S.S., Bedin V.V., Vishnevsky V.A., Galperin E.I., Goltsov V.R., Darwin V.V., Demko A.E., Dibirov M.D., Dyuzheva T.G., Egorov V.I. et al. Acute pancreatitis. Clinical recommendations. Moscow. 2020:38. (In Russian) URL: https://cyberleninka.ru/article/n/klassifikatsiya-ostrogo-pankreatita-sovremennoe-sostoyanie-problemy

8. Yablonsky P.K., Movchan K.N., Sokolovich E.G., Yakovenko T.V., Tarasov A.D., Bogolyubov M.V., Mamicheva O.Yu. Basic statistical parameters of medical care for patients with acute surgical diseases of the abdominal cavity in St. Petersburg. Bulletin of the Novgorod State University named after Yaroslav the Wise. 2013;71:64–70. (In Russian) URL: https://cyberleninka.ru/article/n/osnovnye-statisticheskie-parametry-okazaniya-meditsinskoy-pomoschi-bolnym-ostrymi-hirurgicheskimi-zabolevaniyami-organov-bryushnoy

9. Baulin A.A., Averyanova L.A., Baulin V.A., Baulina O.A. The importance of the diagnostic algorithm at the stages of routing patients with acute pancreatitis. Bulletin of SurGU. Medicine. 2022;4(54):36–40. (In Russian) DOI 10.34822/2304-9448-2022-4-36-40. URL: https://cyberleninka.ru/article/n//vazhnost-diagnosticheskogo-algoritma-na-etapah-marshrutizatsii-patsientov-s-ostrym-pankreatitom

10. Azizov E.M., Yakovenko T.V., Movchan K.N., Ladin S.E., Yakovenko D.V. Possibilities of improving the quality of medical care for patients with acute pancreatitis within the framework of the project “result-oriented budgeting”. Preventive medicine-2020. Сollection of scientific papers of the All-Russian scientific and practical conference with international participation. St. Petersburg. 2020:12–16. (In Russian) URL: https://elibrary.ru/item.asp?id=44778015&selid=44778172

11. Petrov M.S., Yadav D. Global epidemiology and holistic prevention of pancreatitis. Nat. Rev. Gastroenterol. Hepatol. 2019;16(3):175–184. (In Russian) URL: https://tr-page. yandex.ru/translate?lang=en-ru&url=https%3A%2F%2Fpubmed.ncbi.nlm.nih.gov%2F30482911%2F

12. Styazhkina S.N., Galyautdinova A.I., Mannanova D.R. Modern methods of diagnosis of acute pancreatitis. Modern Science. 2020;9–2:208–215. (In Russian) URL: https:// elibrary.ru/item.asp?id=44003782

13. Scriabin O.N., Movchan K.N., Tatarkin V.V., Klitsenko O.A., Morozov Yu.M., Yakovenko T.V., Artyushin B.S. The role of thematic examination of the quality of medical care in improving the results of its provision in acute pancreatitis. Bulletin of the Russian Military Medical Academy. 2020;1(69):105–112. (In Russian) URL: https:// journals.eco-vector.com/1682-7392/article/download/25977/20124

14. Demin D.B., Funygin M.S., Solodov Yu.Yu., Sobolev Yu.A., Gusev N.S. On the need to rethink therapeutic tactics in acute pancreatitis in the mass surgical consciousness. University clinic. 2017;4–1(25):47–50. (In Russian) URL: https://elibrary.ru/item.asp?id=28139694

15. Savin D.V., Demin D.B., Zheleznov L.M. Acute severe pancreatitis as a surgical problem at the present stage. Medical science and education of the Urals. 2022;23(109):132–135. (In Russian) URL: https://bik. sfu-kras.ru/elib/view?id=edselr-edselr.48166767&service=eds

16. Glabai V.P., Gridnev O.V., Bashankaev B.N., Bykov A.N., Krylov A.V., Kaprin I.A., Eldarova Z.E., Varyasova A.A. Surgical tactics in the acute stage of biliary pancreatitis. Surgery. The magazine named after N.I. Pirogov. 2019;11:37–41. (In Russian) URL: https://www.mediasphera.ru/issues/khirurgiya-zhurnal-im-n-i-pirogova/2019/11/1002312072019111037

17. Durleshter V.M., Andreev A.V., Kuznetsov Yu.S., Gabriel S.A., Pykhteev V.S., Shterev V.V., Remizov S.I. Mini-invasive surgical interventions in the treatment of patients with severe acute pancreatitis. Surgery. The magazine named after N.I. Pirogov. 2020;4:30–36. (In Russian) URL: https:// www.mediasphera.ru/issues/khirurgiya-zhurnal-im-n-i-pirogova/2020/4/1002312072020041030

18. Vasiliev A.A., Shirshov I.V., Smirnov N.L., Yelsky I.K. Ways to reduce mortality in patients with infected necrotic pancreatitis. University clinic. 2017;3–1(24):35–39. (In Russian) URL: https://elibrary.ru/item.asp?id=30744478

19. Detectives D.S. Tactics of surgical treatment of patients with acute pancreatitis. News of the Russian Military Medical Academy. 2020;39(S1–1):255–257. (In Russian) URL: https://journals.eco-vector.com/RMMArep/article/view/43448

20. Deraz A.M., Chernyadyev S.A. Duodenal hypertension and decompression in patients with necrotic pancreatitis of biliary origin. Ural Medical Journal. 2018;(10):127–130. (In Russian) URL: https://umj.usma.ru/jour/article/view/331

21. Gulikyan G.N., Pakhomova R.A., Vinnik Y.S., Kochetova L.V., Fedotov I.A. Pancreatitis is a disease of the XXI century. Surgical practice. 2019;4(40):48–52. (In Russian)

22. Questionnaire “Quality of life assessment” SF-36 (In Russian) URL: https://www. georgtech.ru/wp-content/uploads/2019/09/SF-36

23. Kit O.I., Samoylenko N.S., Franzyants E.M., Soldatkina N.V., Sagakyants A.B., Kharagezov D.A., Dashkov A.V., Milakin A.G., Poluektov S.I., Tolmakh R.E., Kaymakchi D.O., Gevorkyan E.Yu., Kolesnikov V.V., Shevchenko N..A. Stomach cancer: modern directions of fundamental research. Modern problems of science and education. 2019 ;4. (In Russian) URL: https://science-education.ru/ru/article/view?id=28956

24. Ruchkin D.V., Kozlov V.A. Reconstructive surgery for recurrent stomach cancer. Oncology. Journal named after P.A. Herzen. 2019;8(5):340–347. (In Russian) DOI: 10.17116/onkolog20198051340.