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Surgical treatment of patients with postoperative ventral hernias is one of the most pressing problems in herniology. Verification of the diagnosis of postoperative ventral hernia is usually not difficult. At the same time, there may be difficulties in diagnosis associated with determining the true size of the hernia orifices, the contents of the hernial sac. These moments are determined by various factors: the location of the hernia on the anterior abdominal wall, the age, sex of the patient, as well as anamnesis of hernia and the volume of surgery previously performed. One of the very rare situations in external abdominal hernias is the situation when the content of the hernial sac is the part of the parenchymal organ, the tumor process, as well as foreign bodies. The study presents the observation materials of three patients admitted for diagnosis and treatment to the surgical hospital clinics of Irkutsk State Medical University. When examined and treated, it was found that in one case the content of the hernia sac included a part of the left lobe of the liver, in another observation, the inguinal hernia sac contained metastatic carcinoma, in the third case – a foreign body was found. All patients underwent surgery (hernioplasty, hernioplasty). Diagnosis of hernia of the anterior abdominal wall was confirmed. A literary search was made for rare clinical examples in herniology. In the world literature, there are only eight observations when the content of the hernia sac was a part of the lobe of the liver; the presence of metastatic carcinoma and a free foreign body we found as single observations described by known specialists in herniology.

Background: The prevalence of varicose veins of small pelvic veins in women of reproductive age varies widely – from 5.4 to 80 %, due to the low specificity and low sensitivity of clinical diagnostic techniques, and the absence of biomarkers that can be used to identify the formation and progression of varicose veins of small pelvic veins in women.Aims: To identify changes in the levels of parameters of the system “lipid peroxidation – antioxidant protection” with the development of varicose veins of the pelvis in women, as well as the possibility of their diagnostic use.Materials and methods: We examined 200 women with clinical signs of varicose veins of small pelvis. Control group included 30 women without any pathology of venous system. Treatment group included 137 women with varicose veins of small pelvis: with mild degree of severity – 39 women, with moderate degree of severity – 65 women, with severe degree of severity – 33 women. We performed comparative analysis of lipid peroxidation – antioxidant defense system in women with and without varicose veins of small pelvis taking into account the severity degrees of pathological process.Results: We obtained the most informative indices for lipid peroxidation – antioxidant defense processes in blood of women with varicose veins of small pelvis: concentration of diene conjugate (DC) for the mild degree of severity of pathological process, lipid hydroperoxide (LHP), DC and malonic dialdehyde (MDA) – for the moderate and severe degree of severity, and also changes in the activity of antioxidant enzymes with increase of the severity of the disease. Assessment of the level of catalase (Cat) and glutathione peroxidase (GP) showed their highest informative value at the mild degree of severity. Concentrations of glutathione reductase (GR), glutathione S-transferase (GST) and reduced glutathione (GSH) are more statistically significant markers for severe forms of pathological process.Conclusions: Our research showed the relevance and advisability of the studying the levels of lipid peroxidation – antioxidant defense indices in women with varicose veins of small pelvis. We registered the highest diagnostic value of DC, Cat and GP in the beginning of the disease and of LHP, DC, MDA, GR, GST and GSH – at severe forms of the pathological process. We obtained reference values for DC, MDA, Cat, SOD and GP concentration that can be considered as the predictors of the development of varicose veins of small pelvis.

The article describes participation of immune system in pathogenesis of varicose vein of pelvis minor. The study revealed elevation of proinflammatory cytokines, discovered disturbances in cellular and humoral units of immunity. Indicated changes are evidence for inflammatory character of changes in venous vascular wall, causing its destruction and varicose dilatation.

In the article the complex therapy of varicose vein disease of pelvis minor in women is suggested; it includes phlebotropic, metabolic and immunotropic drugs. Indicated scheme of treatment lead to improvement of hemodynamic parameters of venous system of pelvis minor. Positive changes of parameters of cytokine, cellular and humoral units of immune system are evidence for decrease of inflammatory response of venous vascular wall.