Russian medicine is being improved thanks to the work of scientists and doctors. So, during the Soviet Union, the outstanding medical scientist Rozanov Vladimir Nikolaevich, who was born in 1872, was given the same name by the medical term - Rozanov's symptom.
The second name for the cause-effect manifestations of the disease is as follows: the symptom of "vanka-vstanka."
What it is
Rozanov's symptom is a manifestation of internal peritoneal accumulation of blood with a rupture of spleen tissue. There are signs of this symptom exclusively in surgery.
Symptom Rozanova (symptom of "vanka-vstanka"): signs
- Body mobility - a constant change of position.
- Yellowness and pallor of the skin. Increased bleeding, accumulation of blood in the abdominal cavity give the face a pale yellow color, indicating a loss of blood.
- The patient often has an increase in temperature in the region of 37-38 degrees.
- Pain in the area of the center of the abdomen, with a return to the area of the spleen.
A patient who is diagnosed and treated constantly maintains the following position: lying on his side, exclusively on his left, with both legs pressed to the lower abdomen. When attempts are made to change the patient’s position, after a few seconds he again takes the position, lying on his left side with his legs pressed to the abdomen.
Another manifestation of the symptom, thanks to which it is called the symptom of “vanka-vstanka,” is the severity of breathing. Initially, with severe shortness of breath, the patient tries to sit down and press his hands to his stomach, but squeezing the diaphragm makes breathing more difficult. Then the patient gets up and tries to walk. But this situation also begins to bring inconvenience.
Then he takes a horizontal position, due to pain in the peritoneum, lying on his back. In such cases, shortness of breath intensifies and he gets up. Such constant changes in body position led to the name - a symptom of Rozanov ("vanka-vstanyka").
With sudden movements, especially if the patient sat, and then gets up, he has a fainting condition. This is another reason why he lays down again. The choice of the left side is due to the location of the spleen in the abdominal cavity.
Symptom Rozanova (symptom of "vanka-vstanka"): causes
As mentioned above, a symptom of Rozanov is the consequences of rupture of the spleen, but it is necessary to understand in what situations this can happen:
- Injuries resulting from car accidents. The specifics of car accidents, when the driver beats the abdomen against the steering wheel, flies out of the passenger compartment, etc.
- Sports injuries. Large physical exertion during sports activities can lead to rupture of internal organs.
- Weight lifting, efforts incompatible with the resources of the body, also lead to rupture of internal organs
- stab-cutting wounds of the abdominal region can lead to rupture of the spleen.
Given the specificity of the injury, primary suspicion appears after the patient voices the circumstances of what happened to him. Further, under the supervision of a doctor. Also, if there were no other injuries, the patient may consult a doctor a little later, for example, a gastroenterologist due to pain in the abdomen.
The doctor asks the patient to first tighten the abdominal muscles, then relax. In the event that a symptom of Rozanov is observed (a symptom of a "vanka-vstanka"), the patient experiences sharp pain due to exposure to the stomach.
Basic diagnostic methods
The symptom of “vanka-vstanki” is diagnosed as follows:
- Interrogation of the patient.
- Visual inspection, palpation of the abdomen from the outside.
- Rectal and vaginal examination.
- Ultrasound of the abdomen.
- The study of blood tests.
- The study of laboratory tests.
The basic rules for a doctor in determining the symptoms of Rozanov
Do not ask direct questions that determine the symptoms. For example, the question: “Do you feel sharp pains in the lower abdomen?” It’s better to ask: “What are your feelings now?” It is important to hear from the patient a detailed description of the sensations he experiences.
Palpation of the abdomen is always very painful in such cases. Therefore, it is better to start it from the area surrounding the painful point of the area, slowly moving towards it.
When examining the abdomen, it is necessary to carry out pressure on its entire perimeter to study the opposite and upper from the lower walls of the peritoneum.
After examining and diagnosing Rozanov’s symptom (“vanka-vanka”), the primary manifestations are removed due to pain medication therapy. The second stage is abdominal surgery.
Related moments
The symptom of “vanka-vstanka” is characteristic of intra-abdominal bleeding due to rupture of the spleen. Often due to additional diseases, Rozanov's symptom and spleen rupture itself are difficult to determine. Together with rupture of the spleen, ruptures of tissues of other organs of the abdominal region can be diagnosed. For example, damage to the liver, colon, stomach, etc.
These lesions can also cause bleeding, blood accumulation in the abdominal region. To exclude other diseases, an extensive comprehensive diagnosis is carried out.
The patient is examined by a number of doctors:
- The therapist - to refer to a number of other specialists.
- Gynecologist - to exclude rupture of the ovaries, which can also cause intra-abdominal bleeding
- Proctologist - to exclude intestinal diseases with surgical symptoms: in the intestine, rectum.
- Urologist - to exclude damage to the genitourinary system.
- Gastroenterologist to rule out the fact of gastric bleeding.
The patient undergoes a series of examinations prescribed by the doctor, after which a recommendation is made for surgical intervention if a positive symptom of “vanka-vstanka” is diagnosed.
Initially, when examined using ultrasound diagnostics, due to a large accumulation of blood in the abdominal region, the internal organs are poorly visualized, which complicates the diagnostic process. In connection with these, they act by the method of exclusion and examine each organ individually.
Thanks to laboratory and clinical blood tests, the inflammatory process in the body is determined.
Postoperative condition
After the surgery, in order to treat spleen rupture, Rozanov's symptom does not manifest itself. The patient no longer experiences the sensations that forced him to change position constantly.
After surgery, the patient is prescribed drug therapy. A number of antibiotics are prescribed, as well as medications that increase the level of immunity. Nonsteroidal pain medications are also prescribed. Give recommendations for a healthy diet for a particular type of diet.
Actions for suspected Rozanov symptom in everyday life
It is important to remember that the symptom of “vanka-vstanka” is characteristic of damage to the spleen. If the patient experiences discomfort, constantly lies down and gets up, experiences pain in the abdominal region, the following measures must be taken:
- Measure the patient's temperature and fix it.
- To provide the patient with comfortable conditions for horizontal position.
- Do not give painkillers on your own.
- Urgently call an ambulance or take the patient to the emergency room of the nearest medical facility.
The patient should tell the doctor in detail under what circumstances he began to experience pain, how long the temperature lasts and what he feels, etc.
Precautions
Do not lift weights more than 15 kg on your own. Internal organs are very sensitive, and sudden movements in the process of lifting weights can lead to their rupture. It is better to wait for time and attract an additional number of people as a precaution.
If a person with a stab-cutting wound is found in the abdominal region, apply a sterile dressing to the wound to hold the blood and immediately provide transportation for medical care. If we are talking about car accident victims discovered by other drivers on the road, urgently inform the law enforcement authorities about the presence of the patient.
Giving help
Since Rozanov’s symptom (symptom of “vanka-vstanka”) is a sign of intraperitoneal bleeding during rupture of the spleen, it must be taken into account that intraperitoneal bleeding does not manifest itself immediately. The patient begins to experience the slightest discomfort, then feels bloated in the abdomen. The stomach becomes hard and heavy.
Then, first, pressing pains begin to appear, with sharp movements and loads on the abdominal cavity intensifying. There are pains in the area of the spleen, extending to the entire abdominal cavity. Then the temperature begins to rise. The temperature keeps constantly in the region of 37-38 degrees.
The skin of the patient takes a yellowish-cyanotic color due to severe loss of blood. He experiences weakness, muscle pain, nausea, and dizziness. It may briefly lose consciousness. It moves with difficulty, movements slow down, pain intensifies in an increasing manner.
It is necessary in such cases to immediately seek medical attention. Otherwise, there may be irreversible consequences, including death. In the abdominal cavity, a deep inflammatory and infectious process can begin, which leads to the development of other diseases. The situation may be complicated, and it will be too late for surgery.
In this regard, upon admission of patients with suspected internal bleeding, doctors conduct an immediate diagnosis and diagnosis. Sometimes minutes can play a crucial role. The issue of treatment is as acute as the diagnosis. With the manifestations of Rozanov's symptom, diagnosis and treatment can take place urgently on the same day.
Contribution to Medicine
The contribution of the medical scientist Rozanov to the field of medicine is enormous. The symptom discovered by him and the examination method are used by medicine today.
To determine and diagnose rupture of the spleen, as well as the subsequent intraperitoneal bleeding, a complex of certain symptoms is used. The symptom of “vanka-vstanki” is described in the educational literature for students of medical colleges and institutes. This is an invaluable contribution to Russian science and domestic medicine, which is still relevant today.