FEATURES OF SURGICAL TREATMENT FOR UTERINE FIBROIDS AND THYROID PATHOLOGY IN THE ANAMNESIS

The purpose of this study is to study the features of surgical treatment for uterine fibroids and thyroid pathology in the anamnesis. The results of the management tactics of patient S., 42 years old, who received specialized medical care in the gynecological department of the State Medical University named after V.D. Seredavin, were studied. A complication in the early postoperative period, such as hemoperitoneum, was caused by bleeding from a branch of the uterine artery on the left. It could have been caused by the consequences of a previous thyroid extirpation operation performed in connection with thyroid cancer (PT3N0M01 stage, 3 cells gy) 5 years ago, as well as the large size of fibroids, the presence of a large number of varicose veins of the pelvis. Thyroidectomy can lead to a state of hypoparathyroidism, followed by a decrease in calcium levels. Calcium deficiency in the body creates conditions for disruption of the normal function of the vascular wall, its rigidity and leads to its calcification. Therefore, even despite adequate hemostasis performed intraoperatively in patients with this operation in the anamnesis, in the postoperative period during subsequent operations, a complication may occur caused by a violation of the tone of the vascular wall, in this case, branches of the uterine artery and lead to intra-abdominal bleeding and the formation of hemoperitoneum. Due to the implementation of careful, dynamic monitoring of the patient's condition, this complication was detected and stopped in a timely manner. Based on the study of this case, it can be concluded that patients who have had a history of thyroidectomy need the most careful monitoring during their surgical procedures, since they have additional risk factors for postoperative complications, in particular, bleeding, due to disorders of the structure and function of the vascular bed caused by disorders associated with removal of an important endocrine organ.