[Application of ultrasonographic investigation and computer tomography in diagnosis and the treatment method choice of complex postoperative hernias of the abdominal wall].

The work is based on analysis of the results of the abdominal hernia (AH) and the anterior abdominal wall state investigation in 48 patients of the main group and in 20--of a control one, using ultrasonographic examination (USE) and computer tomography (CT). The parameters of hernial localization, the hernial sac size and content, the hernial gates size and quantity, as well as the degenerative changes severity of the abdominal wall musculo-aponeurotic structures were investigated in the patients, suffering complex postoperative AH. Degenerative changes in the anterior abdominal wall musculo-aponeurotic structures, more pronounced in the patients older than 50 years, and also in the presence of large and giant AH, especially while their durable persistence, were revealed according to the USE and CT data obtained. In 2 (4%) patients the hernial sac localization was estimated incorrectly due to its migration into the subcutaneous layer. The clinical examination data discrepancies on the issue of a hernial gates size in patients with large and giant postoperative AH were eliminated due to the CT data application. The index "a relative hernial volume", which was calculated, using formula, containing a hernial lump and abdominal cavity volumes, measured, according to the CT data, was applied for the hernioplasty method choice. The USE and CT data permit to reveal the hernia, even in its preclinical stage, and concurrent diseases of abdominal organs as well, securing to choose an optimal surgical tactics, thus promoting the lowering of postoperative complications and recurrences frequency.