Архивъ внутренней медицины (Feb 2018)
TRAVEL TO COUNTRY IATROGENIC. YATROGENIYA DIAGNOSTIC PROCEDURES (Message 3)
Abstract
A special group of iatrogenic complications are associated with various diagnostic manipulations — from a physical examination of the patient to angiographic studies, diagnostic laparoscopy or thoracoscopy. The article presents data on the frequency and nature of diagnostic iatrogenic in clinical practice. The range of diagnostic iatrogenesis in terms of its manifestations, severity and prognosis is wide enough — from skin irritation with gel during ultrasound to dissection of the coronary artery during coronary angiography. The article presents examples of iatrogenic diagnostic procedures, starting with the clinical examination process (collection of complaints and anamnesis, physical examination), and ending with complex invasive examinations. Yatrogenia, which occur with the use of preparations containing contrast (in particular iodine-containing drugs), which are widely used in clinical practice (CT with contrasting, angiography, etc.) with a diagnostic purpose, are considered in detail. The article describes the risk factors, knowledge of which and awareness of their presence in the patient are mandatory before the introduction of drugs containing contrast. The review of complications arising during endoscopic examinations was carried out. The author reminds that iatrogenic events in endoscopic procedures can be manifested not only by complications from the organ under examination (esophagus, stomach, intestines), but also depend on the patient’s condition, his preparation for the procedure, and the specialist’s possession of endoscopic technique. In conclusion, the author gives a clinical observation in which the risk factor of the iatrogenic event was the presence of an anomaly in the liver and pancreas duct systems in the patient. The author of the article encourages colleagues to pay more attention to the process of making a decision to conduct a diagnostic study, always to evaluate the benefit / risk ratio in terms of the real usefulness of the diagnostic study for the patient and the risk of complication development.
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