Pertenko D. Diagnostics of large and giant ventral hernias with method of multispiral computed tomography.

The manuscript presents the results of radiologic examination of 88 patients, I group encountered 48 patients with large and giant ventral hernias, II group - 40 patients with small and medium ventral hernias. On the basis of conducted study the classification of ventral hernias depending on the hernial sac volume was proposed. The expansion of MSCT examination with joining of Valsalva's functional maneuver and delayed phase of scanning gave a possibility to get a maximal possible parameters of hernial sac in large or giant ventral hernias and to assess the functional state of abdominal cavity without enlargement of radiation exposure. Post-processing was improved with use of volume rendering and curvilinear reconstruction oriented along linea alba and rectus muscles with necessary passage through a zone of hernial orifice. The algorithm of MSCT examination and prognosis of abdominal compartment syndrome (ACS) was worked out on the basis of conducted research in patients with large and giant ventral hernias. The prognosis of ACS with help of grades of RPACS index (0-6 - low, 6-12 - medium, over 12 - high) allowed to timely modify the preoperative preparation and its length, to prevent the emergence of ACS.