II. Choose the proper Ukrainian equivalents to the English words and word combinations:

morbidityrecurrence ratesutureanastomotic leakagegastric resectionшоврезекція шлункапросочування через анастомозрівень захворюваностірівень рецидиві

в

3. Complete the following sentences by adding the proper ending.

   1. To control bleeding and prevent recurrence of ulcer the doctor must ... .

   2. Bleeding from a chronic gastric ulcer is best controlled by ... .

   3. Gastric ulcers are not infrequently located in ... .

4. Give the Ukrainian equivalents of these words and word combi­nations and use them in the sentences of your own.

Peptic ulcer disease, recurrence rate, elective operation, time-con­suming procedure, active bleeding, ligation.

3. Be ready to discuss the text.

PERITONITIS

Infectious agents or foreign matter within the peritoneal cavity are responsible for the inflammation. Organisms most commonly encountered are normal inhabitants of the gastrointestinal tract, chiefly the gram-neg­ative coliform bacteria and streptococci, enterococci, A. aerogenes, B. proteus and staphylococci.

Initially, the transparent and glistening peritoneum becomes dull, opaque, and injected. An exudate forms, serofibrinous at first, and later purulent. In time, coils of intestine and the omentum may be glued together by the exudate. Localization of the process with abscess forma­tion is a common sequel.

Clinical manifestation vary, depending on the etiologic agent, the underlying disease, and the virulence and extent of the peritonitis that develops. In the acute case, the patient is prostrated by severe constant pain. Tenderness and pain may be maximal in the general area of an underlying disorder, such as appendicitis, perforated ulcer, or strangu­lated bowel. Since movement intensifies the pain, the patient lies quietly, with shallow respiration, and tends to draw up his thighs and hunch hi« shoulders.

Abdominal inflammation is accompanied by rising temperature and pulse, chills and leucocytosis of 10.000 to 50.000; With progressive peri­tonitis, toxemia, tachycardia, dehydration and electrolyte imbalance add to the gravity of the situation. The patient exhibits great anxiety, some­times bordering on confusion, often manifested by "hippocratic" facies. In localized peritonitis, the systemic and abdominal findings tend to be less severe, with abdominal pain, spasm, tenderness and rebound tender­ness clearly maximal in the area of peritoneal irritation. Hiccups may indicate involvement of the diaphragmatic peritoneum.

Chronic peritonitis may be responsible for any combination of the above symptoms, but the systemic and abdominal manifestations usually are much milder and of longer duration than in the acute form. Fibrinous adhesions may cause intestinal obstruction. Peritonitis arising from tuberculosis or gonorrhea may differ considerably from that found in other forms of the disease.

Antimicrobal therapy, maintenance of electrolyte balance and surgi­cal skill have greatly reduced the mortality of peritonitis.