For a comprehensive study of chronic gastritis’ endoscopic and morphological features with the development of precancerous changes of gastric mucosa CG Hp (+) and CG Hp (-) patients living permanently or temporarily in Yakutia were examined. The study was conducted based on a data from the Republican Hospital No. 1 - the National Center of Medicine of the Republic of Sakha (Yakutia). Some notable features of the morphologic pattern of chronic gastritis HP-negative and HP-positive are noted during the study. In patients with Helicobacter pylori identified during cytological examination, the degree of activity of the inflammatory process of the gastric mucosa during chronic gastritis was more pronounced and was accompanied by severe medical disorders in Yakutian conditions. Metaplastic changes in the gastric mucosa can be attributed to chronic gastritis of an infectious helicobacter nature, and these changes demonstrate profound violations of the processes of regeneration and differentiation of the gastric epithelium, metaplasia, mucosal atrophy, and dysplasia of the 1st and 2nd degrees. Patients with severe forms of chronic gastritis (with symptoms such as mucosal atrophy, intestinal metaplasia) have accounted for a larger percentage of patients from the studied group. Based on the obtained data, in patients with Helicobacter pylori established by cytological examination, the degree of activity of the inflammatory process of the gastric mucosa was more pronounced and was accompanied by severe disorders during CG in Yakutia.

Chronic gastritis holds one of the leading roles in the structure of pathology of the upper gastrointestinal tract, with which practicing specialists of related specialties - gastroenterologists, therapists, endoscopists - meet on everyday basis. The up-to-date generalizing system of views on this pathology is presented in the RE.GA.IN. consensus (2024). We have highlighted and structured the most practical points of the consensus in the context of classification and characterization of the main forms of chronic gastritis, emphasized approaches to diagnosis and dynamic observation, illustrated the supporting endoscopic criteria of the disease. Moreover, we paid special attention to the description of endoscopic patterns of normal and pathological findings using modern endoscopic technologies as an integral factor of interdisciplinary interaction between clinicians and diagnosticians. In our work we tried to specifically and thoroughly address the problem of autoimmune subtype of the condition as one of the most clinically significant at the current moment, but at the same time often underestimated forms of chronic gastritis.

Aim. To determine the diagnostic information content of various research methods for diagnosis, differential diagnosis, and determination of the degree of activity of inflammatory bowel diseases. Materials and methods. 210 patients with ulcerative colitis (UC) and Crohn’s disease (CD) were examined. All patients underwent endoscopic colon examination using virtual chromoscopy (NBI) and autofluorescence (AFI), endosonographic examination (EUS), transabdominal ultrasound and computed tomography (CT) of the colon. The indicators of diagnostic and prognostic significance of the methods were calculated. Results. The results obtained during the study showed that the most informative methods for detecting UC and CD are NBI (UC: Se= 81%, Sp= 71%, BC: Se = 75%, Sp= 70%) and EUS (UC: Se = 90%, Sp= 81%, BC: Se = 74%, Sp= 80%). The above methods were also diagnostically and prognostically significant for the differential diagnosis of UC and CD (NBI: Se = 81%, Sp= 73%, EUS: Se = 81%, Sp= 74%). Clarifying the severity of UC inflammation through various examination methods showed the informative value of three methods: NBI (Se = 79%, Sp= 71%), EUS (Se = 86%, Sp= 67%) and CT (Se = 78%, Sp= 61%). Similar data were obtained when identifying the inflammatory phase of CD NBI (Se = 75%, Sp= 71%), EUS (Se = 71%, Sp= 64%) and CT (Se = 74%, Sp= 66%). The detection of neoplasia showed low figures of diagnostic significance of all radiation methods, while both NBI and API were informative (Se = 100%, Sp= 95%; Se = 87%, Sp= 80%, respectively). Conclusion. Summarizing the data obtained, algorithms for the diagnosis of IBD were developed at various stages of the examination of patients.

Given the high prevalence of cardiovascular pathologies, heart failure, as their common outcome, becomes a priority target for therapy and fundamental research. In recent years, increasing attention has been paid to the role of the microbiome in the pathogenesis of cardiovascular events. Under normal conditions, the gut flora and its metabolites are involved in maintaining the body’s homeostasis and represent an important component of immunological defense. In contrast, an imbalance of microorganisms leads to systemic inflammation and metabolic disorders. Gut dysbiosis is found in 90% of patients with cardiovascular diseases and is characterized by reduced microbiome diversity, an increase in pathogenic bacteria, and a decrease in the number of Lactobacillus and Bifidobacterium [8]. These changes can lead to increased levels of toxic metabolites, such as lipopolysaccharides and TMAO, resulting in inflammation, impaired cardiac function, and the realization of an atherogenic effect. The aim of the study was to assess the correlation between the severity of gastrointestinal symptoms and the degree of chronic heart failure (CHF) in cardiology patients. The study involved 159 patients from the cardiology department. The diagnosis of CHF was confirmed clinically, through laboratory tests, and instrumentally. The standard Gastrointestinal Symptom Rating Scale (GSRS) questionnaire was used to assess the severity of gastrointestinal complaints. The result is to reveal “cardiointestinal syndrome” as a new independent term. The study revealed a direct correlation between the severity of gastrointestinal symptoms and the NYHA functional class of CHF, but there were no correlation between EF and functional class of HF.

Alveococcosis is a parasitic disease caused by the larvae of the tapeworm alveococcus and proceeding with the formation of a primary focus in the liver. The parasite’s germination into the surrounding organs and tissues, its steady growth and ability to metastasize make the course of alveococcosis similar in manifestations and outcomes to liver damage by malignant tumors, with the difference that the growth of the parasitic “tumor” is slower. Siberia, the Far East, Transbaikalia and the Volga region are among the largest endemic areas for it in the world. Domestic scientists have made a great contribution to various aspects of the study of alveococcosis. A large number of such patients and the need to provide them with assistance led to the formation of surgical schools for the treatment of liver alveococcosis in these regions of our country. For more than 100 years since the first clinical observations of alveococcosis were described in the literature, Russian researchers have published classical works on the epidemiology, morphology, classification and treatment of alveococcosis. Currently, the only radical method of treating alveococcosis is R0 liver resection, including extended resection with prosthetics of the main vessels; transplantation technologies and liver transplantation are also used, since there are no drugs with an absolute antiparasitic effect. The introduction of liver transplantation into the practice of hepatological centers in our country at the present stage has significantly changed the range and nature of operations performed for liver alveococcosis. A review of the literature on the study and development of surgical treatment of alveococcosis is presented with an emphasis on Russian scientific schools. Conclusion. Liver alveococcosis is a parasitic disease associated with certain endemic zones and characterized by a “malignant” course. Treatment of the liver alveococcosis and its complications is a rather complex task and still has no complete solution, in connection with which, a comprehensive approach to both diagnostics and treatment is advisable.

Aim. To conduct a retrospective analysis of esophageal diseases, against which foreign bodies (FB) were detected, to evaluate the effectiveness of their extraction using various endoscopic instruments. Materials and methods. The results of examination and treatment of 567 patients with suspected FB of the esophagus from 2023 to 2025 were analyzed. There were 246 men (43.4%), 321 women (56.6%). The average age of patients was 46.5±4.7 years. The duration of FB in the gastrointestinal tract in all patients did not exceed 6 hours. Upon admission, all patients underwent an examination of the ENT organs, contrast X-ray of the esophagus and video esophagogastroduodenoscopy with FB extraction using endoscopic forceps “alligator”, “alligator+rat tooth”, endoscopic loop, endoscopic basket. Statistical data processing was performed using the Statistica 10.0 program. Results. Diagnostic EGDS did not reveal any FB in the esophagus in 198 (34.9%) patients. Since FB were food fragments in 188 (94.9%) of them, there was no need to extract them from the stomach. Dental crowns and bridges were extracted with endoscopic alligator+rat tooth forceps or an endoscopic loop from the stomach of 10 (5.1%) patients. Esophageal FB of various types were detected in 369 (65.1%) patients; FB were extracted in 379 patients, including from the esophagus (369 (97.4%)) and stomach (10 (2.6%)). Endoscopic alligator forceps were used to extract fish bones. In case of “meat blockage”, “alligator+rat tooth” forceps and an endoscopic basket were used. Dental crowns were removed with “alligator+rat tooth” forceps, bridge prostheses - with an endoscopic loop. FB was detected in patients with eosinophilic esophagitis (90 (24.4%)), strictures due to chemical burns (67 (18.2%)), achalasia of the esophagus (56 (15.2%)), esophageal cancer (43 (11.6%)) and Barshon-Tishindorf syndrome (16 (4.3%)). In 97 (26.3%) patients, esophageal diseases were not diagnosed. Conclusions. The causes of FB of the esophagus are often its organic and functional diseases. Examination of patients with dysphagia for the purpose of early detection of pathology of the upper gastrointestinal tract, increasing public literacy and informing patients about possible complications of esophageal disease, following a diet and preliminary grinding of food, timely installation of a stent for esophageal cancer will reduce the frequency of esophageal FB.

The aim of the study: to conduct a comparative analysis of the effectiveness of endoscopic hemostasis methods for ulcerative gastroduodenal bleeding associated with the use of nonsteroidal anti-inflammatory drugs (NSAIDs). Materials and methods. We conducted a retrospective comparative analysis of the effectiveness of endoscopic hemostasis methods for bleeding ulcer (BU) associated with the use of NSAIDs in 97 patients in the period from 2023 to 2025. There were 56 men (57.7%), 41 women (42.3%). The average age of patients was 56.2 ± 6.4 years. Patients were divided into groups depending on the method of endoscopic hemostasis. The first group - 36 (37%) patients with injection method of endoscopic hemostasis (IEH). The second group - 32 (33%) patients with endoscopic argon plasma coagulation (APC). The third group - 29 (30%) patients with endoscopic clipping (EC). The groups of patients were comparable by gender and age. Statistical data processing was performed using the Statistica 10.0 program. Results. The groups did not differ in terms of hospitalization time, localization and size of the ulcer defect, as well as the severity of anemia. It was possible to successfully establish stable hemostasis, limited to one procedure, in 76 (78.4%) of 97 patients. The use of EC allowed achieving stable hemostasis in all patients during the first procedure, IEH was performed repeatedly in 8 (22.2%) of 36 patients, and APC - in 13 (40.6%) of 32.The number of deceased patients (5 (5.2%)) was not associated with the method of endoscopic hemostasis; the causes of death were multiple organ failure and severe anemia that could not be corrected. Conclusion. The adopted clinical guidelines for the prevention and treatment of esophago-gastro-entero-colopathy induced by NSAIDs, patient literacy and provision of hospitals providing care to patients with BU with effective methods of endoscopic hemostasis will help improve the treatment outcomes of patients with BU associated with NSAIDs.

Objectives. To evaluate the results of treatment of acute gastroduodenal ulcerative bleeding in patients with ischemic heart disease. Materials and methods. A retrospective study of 174 patients with ischemic heart disease who were hospitalized with acute gastroduodenal ulcerative bleeding in the period from 2016 to 2024 was conducted. There were 112 men (64.4%) and 62 women (35.6%) among the patients. The average age of the patients was 68.4±8.7 years. Results. The efficiency of primary endoscopic hemostasis was 80.5%. In 19.5% of cases, alternative methods were required. Transcatheter arterial embolization was performed in 14.9% of patients, with technical success in 92.3% of cases. Surgical intervention was necessary in 4.6% of patients who experienced a recurrence of bleeding after the ineffectiveness of endoscopic and endovascular methods. Conclusion. The most reliable and safe method of hemostasis in patients with ischemic heart disease is the endovascular method, which is characterized by the lowest frequency of bleeding recurrence (7.7%). The combination of ischemic heart disease and acute gastroduodenal ulcerative bleeding causes diagnostic difficulties, which requires a multidisciplinary approach from both a surgeon and a cardiologist to determine the priority treatment.

The purpose of the study. To study the frequency, development and features of the course of acute pancreatitis in gunshot wounds of the abdomen with and without damage to the pancreas. Materials and methods. The study included 150 civilian patients who suffered gunshot wounds to the abdomen during a local armed conflict during the fighting in Chechnya and in the border regions of the North Caucasus, as well as during a special military operation. The average age was 37 ± 7 years. There were 46 (30,7%) female and 104 (69,3%) male wounded. Results. The presented study shows that the problem of acute pancreatitis in gunshot wounds of the abdomen is urgent. Thus, it was found that this complication is registered in 50,0% of cases of gunshot wounds to the abdomen among the civilian population. The analysis revealed the dependence of the development of acute pancreatitis on the nature of the injury to the internal organs of the abdomen. It was found that this complication most often develops with wounds to parenchymal organs (liver, spleen), as well as with wounds to the pancreas. Moreover, gunshot wounds to the pancreas lead to 100% development of severe acute pancreatitis, regardless of whether a bullet or shrapnel wound, as a rule, acute pancreatitis leads to more severe complications, leading to death. It was found that the development of acute pancreatitis most often develops against the background of a spleen injury, which requires further investigation. Conclusion. The development of acute pancreatitis in gunshot wounds of the abdomen is noted in 50,0% of cases and is accompanied by a mortality rate of 27,3%, while no statistical reliability was obtained for bullet and shrapnel wounds of the abdomen. Factors contributing to the development of acute pancreatitis in gunshot wounds to the abdomen include: injuries to parenchymal organs (pancreas, spleen), as well as a severe and moderate condition on admission according to the VPX-SP scale.

The aim: identifying the role of single nucleotide polymorphism (SNP) carrier rs1800795 (-174G/C) of the interleukin-6 IL6 gene and rs5275 (+ 8473T/C) of the cyclooxygenase-2 PTGS2 gene in the development of acute pancreatitis. Materials and methods: The case-control study involved 296 people diagnosed with acute pancreatitis (OP). There were 124 (41.89%) males and 172 (58.11%) females. By age, patients ranged from 24 to 83 years old, the average age was 44,3±12,6 years. Patients with mild severity OP - 103 (34.79%) people, moderate severity OP - 110 (37.16%) people, severe severity OP - 83 (28.05%) people. The control group amounted to 78 people. In real time determined by the PCR method the frequency of occurrence of ONP rs1800795 (-174G/C) a gene of IL6 and ONP rs5275 interleukin-6 (+ 8473T/C) a gene of PTGS2 cyclooxygenase-2 at sick OP with varying severity. Statistical data processing was carried out using the MS Excel for Windows program and the STATISTICA 10.0 software package. Results: When comparing alleles in patients of all grades with the control group, carriage as a risky variant allele G (rs1800795 (-174G/C) rs1800795 (interleukin-6 IL6 gene) (OR 2,334; 95% CI 1,611-3.381; p < 0.001) and homozygous GG (OR 6.713; 95% CI 2,957-15,242; p < 0.001) genotypes can be considered as a risk factor for the development of acute pancreatitis. Comparison of alleles in patients with severe OP severity and control group allowed to establish that carriage as a risky variant allele of G (rs1800795 (-174G/C) rs1800795 (IL-6) gene (OR 2.320; 95% CI 1.435-3.750; p < 0.001) and homozygous GG (OR 7.607; 95% CI 3.023-19.146; p < 0.001) of the genotype can be considered as a risk factor for the development of severe acute pancreatitis. When comparing alleles in patients of all grades with control, carrying a risky variant G allele of the PTGS2 gene (COX-2) (OR 1.588; 95% CI 1.063-2.282; p = 0.023), is a risk factor for the development of OP. When comparing alleles in patients with severe severity of OP and control group: carrying a risky variant allele G (OR 1.813; 95% CI 1.117-2.942; p = 0.016), can be considered as a risk factor for the development of a severe course of acute pancreatitis. Conclusion: Thus, in residents of Krasnoyarsk, the carriage of both the rs1800795 (-174G/C) IL6 gene and the rs5275 (+ 8473T/C) PTGS2 gene can serve as a predictor of the development of OP and severe disease

Objective: To improve the treatment outcomes for cholecystocholedocholithiasis by refining the technique of minimally invasive biliary interventions. Materials and Methods: The study included 180 patients divided into two comparable groups. Parameters evaluated included stone removal efficiency, operative time, conversion rate, and postoperative complication rate. Results: The hybrid approach statistically significantly reduced operative time (112±10.3 min vs. 120.3±11.5 min; p<0.001). Lithoextraction efficiency (98% vs. 96.5%), conversion rate (8.6% vs. 12.64%), and postoperative complication rate (4.3% vs. 8.05%) were higher in the hybrid approach group; however, the differences did not reach statistical significance. Conclusion: A hybrid method for treating cholecystocholedocholithiasis is preferable, as it reduces surgical time and tends to reduce complications and conversion rates.

Research Objective: In vitro experiment, evaluate the cytotoxicity and acidity of the water extract of new samples of polymer surgical membranes developed by the authors, designed to prevent intestinal anastomosis failure. Materials and methods. The materials of this study were new samples of multicomponent polymer membranes developed on the basis of KSMU o (5 groups differing in the addition of various antibacterial contrast agents) and an implantable biopolymer ElastoPOB membrane (BIOMIR Service JSC, Russia). The acidity of the aqueous extract (pH) of the membranes was evaluated in six study groups. The effect of membranes on the proliferative activity of fibroblasts was also evaluated using an MTT test. The data obtained during the study were statistically processed using descriptive and variational statistics (Me [25; 75]). The significance of the difference in pH values was determined using the Kruskall-Walis test in (p ≤ 0.05), in the case of the MTT test, analysis of variance was used. Results. A comparative assessment of the change in the pH level of the water extract revealed statistically significant differences in experimental groups No. 3, 4, 5 with the values of group No. 6 (p ≤ 0.05). Statistically significant differences were found between the control group (distilled water) and groups No. 1 (p = 0.000032) and No. 2 (p = 0.000029). Samples of these groups affect the proliferative activity of fibroblasts, inhibiting it by 13.75% and 16.25%, respectively. At the same time, no statistically significant effects on the proliferative activity of fibroblasts were found when assessing the cytotactic effect of samples of groups No. 3-6. Conclusion. When conducting an MTT test, samples containing Yogexol, Levofloxacin and Metronidazole do not affect the proliferative activity of fibroblasts, which allows us to recommend for further comprehensive testing. At the same time, the pH of samples of groups No. 3-5 also have lower values compared to groups No. 1-2, 6.

Pilonidal disease (also known as a pilonidal sinus, cyst, or epithelial coccygeal tract) is a narrow channel lined with epithelium that contains hair follicles and sebaceous glands, and opens onto the skin of the natal cleft with one or several pinpoint openings. In recent years, Negative Pressure Wound Therapy (NPWT) has gained increasing prominence, as it ensures effective purulent discharge removal, reduction of edema, stimulation of tissue healing, and a lower risk of recurrence. This article provides a review of modern treatment methods using vacuum systems, their advantages, potential complications, and recommendations for application in the management of pilonidal disease, as well as other coloproctological conditions such as paraproctitis and colorectal anastomotic leakage. Analysis of clinical experience confirms that vacuum therapy is a safe and effective alternative to traditional surgical interventions, provided that the rules of asepsis are followed and the pressure regimen is correctly selected. The implementation of this technology accelerates wound healing, reduces treatment-related trauma, and improves patient quality of life.

The article presents a literature review of modern Russian and foreign publications devoted to the study of prevalence, pathogenetic mechanisms, diagnostics and treatment of postprandial distress syndrome. It is shown that this variant of functional dyspepsia is the most common. In its pathogenesis, the leading role belongs to disorders of relaxation accommodation of the proximal stomach. Existing diagnostic criteria for functional dyspepsia variants are based on anamnestic data, which does not allow for their clear verification. For the purpose of differential diagnostics of functional dyspepsia, along with endoscopic examination, it is advisable to clarify the disorders of gastroduodenal motility and the profile of intestinal peptides regulating it. Modern approaches to the treatment of patients with postprandial distress syndrome include the use of prokinetics and neuromodulators against the background of diet therapy and non-drug correction.

Electroenterocolography (EECG) is a method for assessing the motor-evacuation function of the gastrointestinal tract. EECG helps to identify disorders of motility and nervous regulation, which contributes to a more accurate diagnosis and selection of effective treatment. Modern EGECG is an informative method for assessing the functional state of the entire intestinal tube from the stomach to the colon. EECG can be used to diagnose the nature of disorders, assess the state of the motor-evacuation function of the intestine and personalize the therapy. This article provides a review of the literature on the use of peripheral electroenterocolography to diagnose irritable bowel syndrome.

In patients with IBD the most sensitive markers of ED are VCAM-1, ICAM-1 and vWF, whose levels increase during the active phase and decrease during remission. CRP shows a stable correlation with Crohn’s disease activity, but is less predictive in ulcerative colitis. Levels of ET-1 in IBD remain relatively unchanged; however, changes are observed in experimental models of colitis and in chronic uveitis. ADMA shows ambiguous results in IBD but is elevated in isolated uveitis manifestations, indicating systemic inflammation even in clinically localized lesions.

An arteriovenous fistula (AVF) is an abnormal connection between an artery and a vein, resulting in direct blood flow, bypassing the capillary network. Among the rarest forms is inferior mesenteric AVF, with fewer than 50 reported cases worldwide, according to recent studies. This vascular anomaly can be congenital, iatrogenic, traumatic, or idiopathic. Its clinical significance is associated with impaired intestinal hemodynamics - the development of ischemia, venous congestion, portal hypertension, and cardiac overload. This clinical observation describes a case of spontaneous inferior mesenteric AVF in a 72-year-old female patient with diabetes mellitus, hypertension, and obesity. Symptoms were limited to moderate lower abdominal pain without significant functional impairment. Computed tomography angiography (CTA) revealed early enhancement of the inferior mesenteric vein in the arterial phase - a pathognomonic sign of arteriovenous bypass grafting. Given the patient’s age, comorbidities, and the absence of significant hemodynamic disturbances, a watchful waiting approach with dynamic monitoring of laboratory and instrumental studies was chosen. This case highlights the diagnostic value of CTA as the “gold standard” for mesenteric fistulas and demonstrates the need for an individualized approach to treatment. In patients with asymptomatic cases and high surgical risk, conservative management of inferior mesenteric AVFs is a reasonable and safe solution.

Aim. To present clinical experience with combined management of severe pseudomembranous colitis using the ATLAS scale for risk stratification and therapeutic optimization. For patients scoring 4-6 points on the ATLAS scale, a diverting loop ileostomy is created with intraoperative catheter placement through the efferent limb into the colonic lumen. In the postoperative period, sequential antegrade colonic lavage is administered via the catheter according to the following protocol: vancomycin 125-250 mg, metronidazole 500-1000 mg, and fidaxomicin 200-220 mg in 500 mL of normal saline, followed by rebamipide 100-120 mg in 500 mL of normal saline - administered twice daily with a 6-hour interval for 10 days. Conclusion. The reported case demonstrates the effectiveness of this combined strategy for managing severe Clostridioides difficile-associated pseudomembranous colitis refractory to standard medical treatment.

This index was prepared for the 105th anniversary of the birth of Vladimir Vasilyevich Sumin, an outstanding surgeon, Honored Scientist of the Udmurt Republic, Honorary Academician of the Irkutsk State Medical Academy, and Doctor of Medical Sciences. The index includes bibliographic descriptions of works published by the scientist during his scientific, pedagogical, and professional career.