ALGORITHM FOR DIAGNOSING THE MIGRATION OF FOREIGN BODIES OF GUNSHOT ORIGIN

Resume. The aim is to propose an algorithm for diagnosing the migration of foreign bodies of gunshot origin. Materials and methods. We have analysed 90 cases of gunshot blind wounds of various localisations for a certain period, where there was a foreign body migration by different ways. All the wounded were male, the average age was (43.2±4.1) years. The number of migrated foreign bodies was 104. Multislice spiral computed tomography of the head, chest and abdominal organs, pelvis with and without contrast, radiographic examinations of the head, chest and abdominal organs, ultrasound examination of the heart, blood vessels, joints, abdominal organs, soft tissues, video esophagogastroduodenoscopy, video colonoscopy, video bronchoscopy were performed. Statistica 10 software (StatSoft, Inc., USA) was used for statistical analysis. Statistical processing of the study results was performed using non-parametric statistical methods. Mathematical data processing was performed according to generally accepted methods with the calculation of arithmetic averages. Results. The algorithm for diagnosing the migration of foreign bodies of gunshot origin includes the following steps: examination of the wound site, primary radiography or multislice computed tomography (primary studies); if hollow organs are suspected to be damaged, endoscopic examinations are performed; if major vessels are suspected to be damaged, multislice computed tomography with angiographic contrast (final studies) and control studies: ultrasound, radiography and multislice computed tomography as indicated. Statistical analysis of the multi-stage sequential-parallel model showed an increase in the weighting coefficients from the initial diagnosis to the control diagnosis and indicates an increase in the effectiveness of the final and control diagnosis compared to the initial diagnosis. Conclusions. The increase in the weighting coefficients from the primary to the control examination indicates an increase in the effectiveness of the final and control diagnostics compared to the primary diagnostics. The application of the algorithm for the diagnosis of foreign bodies of gunshot origin allows to determine the treatment tactics and the scope of surgical intervention.