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The means for using prophylactic measures for prevention of the development of the adhesion process in the abdominal cavity are divided by the authors into two groups: for primary and secondary prophylactics. The mechanism of action of means for primary prophylactics is directed to restoration of the peritoneum mesothelium and its function; secondary prophylactics--to prevention of adhesions of scarry regenerated leaves of the parietal and visceral peritoneum. The findings are analyzed. The authors give recommendations for using means against adhesions. The necessity to choose the means for prophylactics depending on the state of the abdominal cavity is grounded (first operation or reoperation, planned or emergency operation). On the basis of the personal experience the authors recommend measures of the primary and secondary prophylactics of the adhesion process.

Ten cases of the fixed omentum syndrome which appeared in women operated on organs of the small pelvis are discussed. The cause of adhesions of the greater omentum and the parietal peritoneum and internal organs was the operative trauma in combination with inflammatory alterations of the peritoneum. The surgical treatment consisted in the division of adhesions of the greater omentum, resection of the omentum portion being fulfilled in cases of its cicatricial alterations. Complete healing was noted in all the patients.

In missed intraoperative injury to the ureter one can regularly observe retroperitoneal urinary overflow (urinary retroperitonitis). In case of postoperative ignorance of the injury the overflown urine penetrates into the vagina with formation of the ureterovaginal fistula. Less frequent there are ureterocutaneous or ureteroperitoneal, ureterointestinal fistulas after the urine breaking into the operative wound, abdominal cavity or the intestine, respectively. A case of a 37-year-old woman is reported with accidental injury to the left ureter overlooked during and after the operation. The patient developed successive ureteroperitoneal, ureterocutaneous and ureterosigmoid fistulas for which she has undergone 4 operations. After the recovery the function of the left kidney was retained.

The authors studied duodenal myoelectric activity and the activity of trypsin, alpha 1-antitrypsin, alpha 2-macroglobulin, alpha-amylase, and kallikrein after 15-minute occlusion of the hepatic portal vein. The correlation was found between the activity of alpha 1-antitrypsin and the phases of the myoelectrical complex. It is concluded that the discharge of pancreatic proteases during an operative trauma may underlie the pathogenesis of postoperative inhibition of intestinal peristalsis.

The authors analyze the usefulness of ultrasonic examination for the assessment of ovarian and endometrial status in 84 patients operated on for tubal and peritoneal sterility. After surgery the patients were recommended nootropic agents and cyclic vitamin therapy for 3 months. In cases with concomitant diseases (endometriosis, small pelvis varicose veins) synthetic estrogen-gestagen drugs, anticoagulants, disaggregants were prescribed. If the treatment did not result in pregnancy in 2 months, ovulation stimulants (clostilbegit, choriogonin) were prescribed. Drug therapy had a favorable effect on ovarian and endometrial function. Ultrasonic examination may be recommended for monitoring ovarian and endometrial status.

Under analysis were 38 observations of primary acute diseases of the greater omentum in children: torsion of the omentum (in 16 patients), idiopathic infarction (in 12), primary omentitis (in 10). These diseases are met in 0.07% of all the patients operated upon with acute abdominal pathology. The absence of macroscopic alterations in the vermiform process or their secondary character, the presence of hemorrhagic exudate in the abdominal cavity are considered to be indications for revision of the greater omentum and its resection if a pathology revealed. All the patients were operated upon and healing followed.

Clinical data (110 observations over 106 cases) and experiments on animals proved the inexpediency of the peritonization of non-pertonized surfaces in children both in "pure" peritoneum and under the condition of a pronounced inflammation. Renouncement of peritonization of peritoneal defects has favoured the decrease of the incidence rate of the recurrence of ileum and the improvement of late results of the treatment. The authors believed that the peritonization is needed only when defects of the intestinal wall reach the submucous level and as this takes place a pronounced bleeding, which cannot be controlled without suturing, is noted. Intestinal perforation localized in the non-peritonized sites was never observed, even when the muscular layer of the intestinal wall was damaged.

A detailed clinical analysis has shown that abdominal tuberculosis in its clinical manifestations and course is characterized by pathognomonic signs which, if properly accounted, can provide an opportunity to avoid frequent diagnostic errors. It is the author's opinion that patients with abdominal tuberculosis should be operated upon only in surgical complications of the latter and after a careful examination, establishing the precise diagnosis and adequate preoperative management.

Complex experimental and morpho-laboratory examinations of 164 patients and 30 animals have shown the daughter bullas implanted into the liver tissue of animals to perish, the cavity being substituted by the connective tissue. In patients with Echinococcosis with the live parasite, suppuration or calcification scolexes were not found or died. In cases with the dead parasite and the destroyed cuticular membrane scolexes could be found in the fibrous capsule cavity and outside its limits. This fact should be taken into consideration when choosing the operative method.

The greater omentum torsion was revealed in 10 of 10143 patients operated upon urgently. The complex of symptoms established by the authors facilitates making the correct diagnosis. It includes a typical pain syndrome, the presence of a mobile tumor-like mass in the abdominal cavity without disturbances in intestinal passage, disagreement between the satisfactory state of the patient and duration of the disease. The operation of choice for the greater omentum torsion is resection of the torsioned lobe. The postoperative period in 9 patients was good. In one patient there was suppuration of the operation wound.