CONCEPTUAL APPROACHES TO THE DIAGNOSIS AND TREATMENT OF PENETRATING GUNSHOT WOUNDS OF THE ABDOMEN WITH DAMAGE TO THE PANCREAS

Summary. The goal is to determine the main directions of the concept of diagnosis and treatment of penetrating gunshot wounds of the abdomen with damage to the pancreas. Materials and methods. A retrospective analysis of the medical records of inpatient patients treated in the VMC of the Northern region, who received combat trauma of the pancreas during the war in Ukraine, was conducted. All the wounded were examined, complaints, medical history were studied, general clinical blood and urine tests were performed, biochemical analysis of blood and abdominal secretions, ultrasound examination of the abdomen and pleural cavity, radiographic examinations of the chest and abdomen, multispiral computed tomography of the chest and abdomen with contrast and without, video endoscopic methods, X-ray spectral and X-ray structural analysis of secretions from the abdomen and pancreatic tissues, electron microscopy, world microscopy, immunohistochemistry, mathematical and statistical methods. The results. The diagnostic component of the concept is implemented through the study of complaint data, anamnesis, local examination, laboratory, instrumental, hardware, histological and immunohistochemical studies. The therapeutic component, which combines conservative and operative measures depending on the patient’s geodynamic stability, is aimed at correcting hemodynamic disorders and influencing the four directions of the conceptual model of treatment of penetrating gunshot wounds to the abdomen with pancreatic damage. It is mandatory to study the foreign bodies of firearm origin that injured the pancreas and the possibilities of modern magnetic surgical instruments for the removal of ferromagnetic foreign bodies. The examination and control of treatment carried out covers research at the atomic and molecular level, at the subcellular level, at the cellular and tissue level, at the organ and clinical levels. All these studies are implemented within the framework of clinical and experimental research design with data analysis using mathematical and statistical methods. Conclusions. Conceptual approaches to the diagnosis and treatment of penetrating gunshot wounds to the abdomen with damage to the pancreas are based on a systematic analysis. The conceptual model is based on the following areas: localization of pancreatic injury, presence or absence of pancreatic duct injury, severity of pancreatic injury according to AAST, presence of combined injuries to other organs.