TRAVEL TO COUNTRY IATROGENIC. YATROGENIYA DIAGNOSTIC PROCEDURES (Message 3)

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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