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Склерозирующий мезентерит как хирургическая проблема: обзор литературы и собственное клиническое наблюдение

https://doi.org/10.21518/akh2024-001

Аннотация

Проблеме изучения патологии брыжеечного жира тонкой кишки в практике хирурга до настоящего времени уделяется недостаточно внимания. Остается нерешенным ряд вопросов, касающихся этиологии и патогенеза заболеваний брыжейки, их возможной связи с доброкачественными и злокачественными заболеваниями, методов их лабораторной и инструментальной диагностики, возможных вариантов консервативного и хирургического лечения, а также систематизации и структурирования классификации. Одним из малоизученных представителей заболеваний брыжейки тонкой кишки продолжает оставаться склерозирующий мезентерит, характеризующийся различными гистологическими вариантами поражения брыжеечного жира и разнообразной неспецифической клинической картиной. В совокупности это приводит к определенным трудностям диагностики, обращаемости пациентов к врачам различного профиля, что в конечном итоге отрицательным образом отражается на результатах лечения и может приводить к социальной дезадаптации и возможной инвалидизации. Сообщения о встречаемости данной патологии в медицинской литературе немногочисленны и, как правило, описывают исключительно редкие клинические случаи. Однако в последние годы частота выявления этой патологии продолжает неуклонно расти, что связано с прогрессирующим старением населения, высокой степенью хирургической активности в отношении ургентных заболеваний органов брюшной полости, совершенствованием методов инструментальной диагностики. Вопросы этиологии, патогенеза, дифференциальной диагностики данного заболевания и его возможной связи с паранеопластическим процессом в настоящее время продолжают вызывать дискуссии. Дальнейшее накопление клинического опыта, лучшее понимание патогенеза заболевания, совершенствование визуализационных методик позволит разработать более четкие диагностические и клинические критерии, сузить диагностический поиск и в конечном итоге улучшить и стандартизировать лечение. В статье приведен обзор литературы, посвященный этой редкой хирургической патологии, представлено собственное клиническое наблюдение, рассмотрены вопросы диагностики и варианты лечения данного заболевания.

Об авторах

Б. В. Болдин
Российский национальный исследовательский медицинский университет имени Н.И. Пирогова
Россия

Болдин Борис Валентинович - д.м.н., профессор, заведующий кафедрой факультетской хирургии №2.

117997 , Москва, ул. Островитянова, д. 1



В. Ю. Богачев
Российский национальный исследовательский медицинский университет имени Н.И. Пирогова; Первый флебологический центр
Россия

Богачев Вадим Юрьевич - д.м.н., профессор, кафедра факультетской хирургии №2, РНИМУ имени Н.И. Пирогова; научный руководитель, Первый флебологический центр.

117997, Москва, ул. Островитянова, д. 1; 117447, Москва, ул. Дмитрия Ульянова, д. 31



П. Ю. Голосницкий
Российский национальный исследовательский медицинский университет имени Н.И. Пирогова; Центральная клиническая больница Святителя Алексия Митрополита Московского
Россия

Голосницкий Павел Юрьевич - к.м.н., доцент, кафедра факультетской хирургии №2, РНИМУ имени Н.И. Пирогова; руководитель центра сосудистой хирургии, ЦКБ Святителя Алексия Митрополита Московского

117997, Москва, ул. Островитянова, д. 1; 117447, Москва, ул. Дмитрия Ульянова, д. 31



П. Ю. Туркин
Российский национальный исследовательский медицинский университет имени Н.И. Пирогова; Центральная клиническая больница Святителя Алексия Митрополита Московского
Россия

Туркин Павел Юрьевич - к.м.н., доцент, кафедра факультетской хирургии №2, РНИМУ имени Н.И. Пирогова; врач-хирург операционного блока, ЦКБ Святителя Алексия Митрополита Московского.

117997, Москва, ул. Островитянова, д. 1; 117447, Москва, ул. Дмитрия Ульянова, д. 31



И. М. Дизенгоф
Российский национальный исследовательский медицинский университет имени Н.И. Пирогова; Центральная клиническая больница Святителя Алексия Митрополита Московского
Россия

Дизенгоф Игорь Михайлович - к.м.н., ассистент, кафедра факультетской хирургии №2, РНИМУ имени Н.И. Пирогова; заместитель главного врача по хирургии, ЦКБ Святителя Алексия Митрополита Московского.

117997, Москва, ул. Островитянова, д. 1; 117447, Москва, ул. Дмитрия Ульянова, д. 31



Д. А. Кобзарев
Центральная клиническая больница Святителя Алексия Митрополита Московского
Россия

Кобзарев Дмитрий Алексеевич - к.м.н., руководитель отделения лучевой диагностики.

119071, Москва, Ленинский проспект, д. 27



В. Ю. Цукан
Российский национальный исследовательский медицинский университет имени Н.И. Пирогова
Россия

Цукан Валерия Юрьевна - студент-субординатор, староста студенческого научного кружка, кафедра факультетской хирургии №2.

117997, Москва, ул. Островитянова, д. 1; Москва, Ленинский проспект, д. 27



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Для цитирования:


Болдин Б.В., Богачев В.Ю., Голосницкий П.Ю., Туркин П.Ю., Дизенгоф И.М., Кобзарев Д.А., Цукан В.Ю. Склерозирующий мезентерит как хирургическая проблема: обзор литературы и собственное клиническое наблюдение. Амбулаторная хирургия. 2024;21(1):136-156. https://doi.org/10.21518/akh2024-001

For citation:


Bogachev V.Yu., Boldin B.V., Golosnitskiy P.Yu., Turkin P.Yu., Dizengof I.M., Kobzarev D.A., Tsukan V.Yu. Sclerosing mesenteritis as a surgical problem: a review of the literature and own clinical observation. Ambulatornaya khirurgiya = Ambulatory Surgery (Russia). 2024;21(1):136-156. (In Russ.) https://doi.org/10.21518/akh2024-001

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