About clinical and pathological aspects in interpretation of estimated data of medical care quality in acute abdominal injury state in cases of COVID‑19 identification (based on model of duodenal ulcer perforation)

Movchan K., Tatarkin V., Darina M., Tvorogov D., Chernov K., Zharkov A., Artyushin B., Povaliy A.

Coronavirus disease usually affects people with metabolism disorders, oncological state, chronic diseases of respiratory system, cardiovascular system and gastrointestinal system. In Saint-Petersburg, in period from March to August 2020 there were discussed 803 lethal cases of people, who have been affected by COVID-19 and died. Separately, the data of 60 surgical diseases was examined. Case of patient with perforated duodenal ulcer and COVID-19 state is discussed in this article. It was found, that in case of coronavirus disease the main role in tanatogenesis plays not only the severe course of disease, but also complications of disease that patients already have (also duodenal ulcers, in particular – perforation). The last one is need to be taken into account via interpretation of data of pathological examination via expertise the medical care quality in cases of perforated duodenal ulcer with COVID-19 state. Difficulties in estimation the root-cause connexion of disease course with lethal exodus are undoubted. Certainly, in severe (not simple) cases of acute abdominal state, the collegial discussion is preferred and should not be as similar as a trial.

Keywords:safety of medical activity, quality of surgical care, acute surgical diseases of abdominal organs, perforated gastroduodenal ulcers, COVID-19, management in urgent abdominal surgery.