Aim. To identify the underlying causes of complications in distinguishing the origin of head masses through a comparative analysis of CT findings and clinical observations.
Materials and methods. A retrospective analysis of radiological imaging for pancreatic cancer (36 cases) and chronic pancreatitis (24 cases) was conducted. Pancreaticoduodenectomy was performed in 23 cases (14 for cancer and 9 for chronic pancreatitis), while drainage interventions were carried out in 35 cases.
Results. On pre-contrast images, pancreatic cancer appeared isodense in 97 % of cases, while in the arterial phase, it was hypodense in 94 %. For chronic pancreatitis, these percentages were 67 % and 46 %, respectively. The density curves of the pancreatic head and normal parenchyma were nearly identical across all phases, but the density gradient difference was more pronounced in pancreatic cancer (27 HU compared to 15 HU). Bile duct strictures with interruption were observed more frequently in cancer (44 %), along with arterial vessel invasion (25 %). CT signs indicative of chronic pancreatitis included wirsugolithiasis (21 %) and portal hypertension (42 %). Both diseases exhibited similar CT features, such as cystic lesions, peripancreatic tissue infiltration and peripancreatic lymphadenopathy. In six cases of pancreatic head cancer and seven of chronic pancreatitis, identical pathological changes were identified during intraoperative revision: pseudocysts (2 in cancer and 4 in chronic pancreatitis), infected necrosis and abscesses (3 and 2, respectively) and similar views of the head mass cut plane (1 each).
Conclusion. The overlap in CT features due to similar pathomorphological changes presents an objective challenge in differentiating pancreatic head masses

Background. The increase in the volume and number of hepatic surgeries is causing a rise in the frequency of postoperative complications, such as acute posthepatectomy liver failure.
Aim. This article investigates changes in integral haematological indices and plasma homocysteine depending on the degree of development of posthepatectomy liver failure.
Materials and methods. The article presents the results of the study of the value of leukocyte indices of cellular reactivity and plasma homocysteine level in 40 patients with different classes of acute posthepatectomy liver failure (PHLF). Patients were divided into three groups: those with postoperative class A, B and C PHLF. Data were analysed before surgical intervention, postoperatively and upon discharge.
Results. A comparison of the average leukocyte indices in groups B and C of PHLF before surgery, postoperatively and upon discharge revealed a rise in most metrics. The notable increase in indicators of the progression and extent of endotoxicosis and inflammatory response suggests their potential use as screening markers for diagnosing and predicting this complication. Moreover, the considerable rise in plasma homocysteine levels in B and C PHLF groups during the postoperative phase indicates a disruption in the synthesis of the acid and correlates with functional liver failure.
Conclusion. The haematological intoxication indices and plasma homocysteine levels ensure early detection of inflammatory response development and are diagnostically significant in identifying acute PHLF.

Aim. This article aims to assess the effectiveness of uroflowmetry in detecting residual urine and to investigate the relationship between the sensation of incomplete bladder emptying, as measured by the IPSS questionnaire, and the presence of residual urine.
Materials and methods. A cohort of patients treated at the Urination Pathology Centre (Vladivostok) for benign prostatic hyperplasia was observed and data were collected. Patients ranged in age from 50 to 73 years (with an average age of 60.5 ± 8.2 years) and were observed during from 2 to 24 months (with an average of 8.4 ± 5.5 months).
Results. The analysis of ultrasound data and uroflowmetry results demonstrates convincingly that the SIGMA uroflowmeter can reliably detect residual urine with a high degree of accuracy (p < 0.01). However, during the study, no consistent correlation was found between the symptom of feeling of incomplete bladder emptying, as assessed by the IPSS questionnaire, and the presence of residual urine detected by the SIGMA uroflowmeter.
Conclusion. Uroflowmetry conducted with the SIGMA uroflowmeter reliably identifies instances of incomplete bladder emptying, as evidenced by comparison with ultrasound data. At the same time, clinical assessment using the IPSS charts, particularly for the symptom of incomplete bladder emptying, does not adequately indicate the presence of residual urine. Uroflowmetry offers a means to identify incomplete bladder emptying and measure residual urine volume without requiring specialised equipment or medical personnel, thus broadening the diagnostic scope for both conservative and surgical treatment approaches.

Background. According to the literature, acromioclavicular dislocations rank third in frequency among all dislocations within the musculoskeletal system. The social significance of acromioclavicular (AC) joint injuries lies in that the majority of affected individuals are part of the working-age population, typically aged 25 to 45 years, frequently involved in physically demanding occupations and high-level sports.
Aim. This article seeks to compare various surgical treatment methods for AC dislocations. Materials and methods. This study analyses current Russian and international literature sources regarding the surgical treatment of AC dislocations. The information sources were examined using the eLibrary and PubMed search engines.
Results and discussion. In current clinical practice, surgical methods are typically preferred when considering treatment approaches for AC dislocations. This preference stems from the significant advantages associated with surgery, including a shorter rehabilitation period and high patient satisfaction with long-term treatment outcomes, despite the risks of postoperative complications.
Conclusion. The most promising methods for stabilising the AC joint include the use of a hookshaped plate and the button suture. While a hook-shaped plate offers greater stability compared to the button suture, it necessitates informing the patient about the need for plate removal three months post-surgery to reduce the risk of osteoarthritis development. On the other hand, the button suture does not require additional surgical procedures for implant removal but may result in less rigid fixation, potentially leading to recurrence of dislocation.

Complications such as scapular notching or artery, nerve and deltoid muscle damage can outweigh the benefits of shoulder joint replacement and result in poor functional outcomes. Reverse shoulder joint replacement may cause traction deformation of the brachial plexus and axillary vessels due to constructive medialistion and distalisation of the shoulder component. Delayed surgery after a fracture can lead to bleeding from damage to the axillary artery wall during the release of scarred soft tissues. Although most neurological complications after reverse arthroplasty (RA) are reversible, some persist, particularly damage to the axillary nerve. These complications can occur due to various reasons such as the use of acute retractors, glenoidal cavity release and humerus traction with further distalisation. Fixing the scapular component with screws can damage the supra-scapular nerve. Deltoid muscle dysfunction remains a serious complication due to axillary nerve damage or muscle fibre ruptures. Notching syndrome occurs when the shoulder component of the endoprosthesis collides with the scapula. Shoulder component dislocation, often caused by insufficient soft tissue tension due to implant misplacement, is not uncommon.
This study was necessitated by the significance of these complications, their varied causes, the relative rarity of reverse arthroplasty, previous shoulder trauma altering anatomy, poor functional outcomes, and diverse problem-solving approaches.

The clinical case discussed in this article highlights the challenge of managing precordial or subxiphoid hernias resulting from previous surgical procedures involving median sternotomy. A 72-yearold patient was diagnosed with a postoperative precordial hernia following coronary artery bypass surgery and sternum removal due to osteomyelitis. A combined surgical approach (open and laparoscopic) was employed for hernioplasty. Positive progress was observed in the patient’s condition shortly after surgery, with pain relief attributed to hernial protrusion correction. The patient was discharged in satisfactory condition on the 4th postoperative day. Although precordial hernias are rare, prompt treatment is essential as large hernias can lead to severe cardiopulmonary complications such as cardiac tamponade. Adequate preoperative preparation and determination of surgical strategy are crucial for successful treatment. This study demonstrates an effective and safe surgical approach for precordial-diaphragmatic hernias.

Background. Tenosynovitis and longitudinal rupture of the tendon of the long fibular muscle linked to hypertrophy of the fibular tubercle of the calcaneus are relatively uncommon conditions. The literature has documented isolated clinical cases, but there is a lack of comprehensive research on diagnosing and treating these ailments.
Aim. This article seeks to present an effective surgical treatment option along with mandatory diagnostic blockade for a patient with hypertrophic fibular tubercle complicated by tenosynovitis and longitudinal rupture of the tendon of the long fibular muscle.
Case description. This article describes a rare clinical case involving tenosynovitis and longitudinal rupture of the tendon of the long fibular muscle, which is associated with hypertrophy of the fibular tubercle of the calcaneus. After examination, diagnostic blockade and unsuccessful conservative therapy, the decision was made to pursue surgical intervention.. The surgical procedure involved resection of the fibular tubercle and tubularisation of the tendon of the long fibular muscle. Eight months after treatment, there was no recurrence of symptoms.
Conclusion. This clinical case illustrates the successful outcome of surgical intervention for a patient with hypertrophic fibular tubercle tenosynovitis, and longitudinal rupture of the tendon of the long fibular muscle. Diagnostic blockades can be beneficial for identifying the primary cause of foot pain and devising appropriate treatment strategies.