A criterion of choice for surgical intervention in children with appendicular peritontis

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Abstract

Purpose: to select the surgical approach in appendicular peritonitis using the peritonitis index and laparoscopic intraoperative assessment of abdominal inflammation intensity.

Methods and materials: experience of treating 186 patients with appendicular peritonitis is presented. Retrospective analysis of medical records of 186 patients with complicated appendicitis in 2011–2014 was performed. It was accompanied by prospective analysis substantiating the criteria for laparoscopic intraoperative assessment of the intensity of abdominal inflammatory changes in 2015 to 2018.

Results. In our study, there were 98 cases (52.6%) of local peritonitis in the total structure of peritonitis (186 cases). 57 cases (30.6%) of diffuse peritonitis were observed. Among patients with acute appendicitis (1863 cases) during the examined period, local peritonitis was found in 5.2% of patients, diffuse peritonitis – in 3.05% of patients.

Conclusion: criteria assessing the intraoperative severity of peritonitis enabled to decrease the rate of laparotomy from 9.1% to 6.45%.

About the authors

Alexander A. Sleptsov

North-Eastern Federal University in Yakutsk; Pediatrician Center of Republican Hospital No. 1, National Center of Medicine

Author for correspondence.
Email: sashaogh@mail.ru

Student of the Pediatric Surgery Department, Medical Institute, North-Eastern Federal University named after M. K. Ammosov, Head of the Purulent Surgery Department of Pediatric Center, Republican Hospital № 1, National Centre of Medicine

Sergelehskoe highway, 4, Yakutsk, Republic of Sakha (Yakutia), 677010, phone: 8(4112)39–56–69

Russian Federation

Valentina A. Savina

North-Eastern Federal University in Yakutsk

Email: SavvinaVA@mail.ru

Dr. Sci (Med), Professor of Pediatric Surgery Department, Medical Institute, NorthEastern Federal University named after M. K. Ammosov, chief part-time surgeon of Ministry of Health, Republic of Sakha (Yakutia)

Oyunskogo str., 27, Yakutsk, Republic of Sakha (Yakutia), 677010, phone: 8(914)225–30–94

Russian Federation

Ahmed R. Varfolomeev

North-Eastern Federal University in Yakutsk

Email: fake@neicon.ru

Dr. Sci (Med), Professor of Pediatric Surgery Department, Medical Institute, North-Eastern Federal University named after M. K. Ammosov

Oyunskogo str., 27, Yakutsk, Republic of Sakha (Yakutia), 677010, phone: 8(924)168–74–09

Russian Federation

Valentin N. Nikolaev

North-Eastern Federal University in Yakutsk

Email: fake@neicon.ru

Assistant professor of Pediatric Surgery Department, Medical Institute, North-Eastern Federal University named after M. K. Ammosov

Oyunskogo str., 27, Yakutsk, Republic of Sakha (Yakutia), 677010, phone: 8(924)360–54–72

Russian Federation

Eduard I. Petukhov

Pediatrician Center of Republican Hospital No. 1, National Center of Medicine

Email: fake@neicon.ru

Pediatric surgeon of the Purulent Surgery Department of Pediatric Center, Republican Hospital № 1, National Centre of Medicine

Sergelehskoe highway, 4, Yakutsk, Republic of Sakha (Yakutia), 677010, phone: 8(4112)39–56–69

Russian Federation

Alexey L. Zuev

Pediatrician Center of Republican Hospital No. 1, National Center of Medicine

Email: fake@neicon.ru

Pediatric surgeon of the Purulent Surgery Department of Pediatric Center, Republican Hospital № 1, National Centre of Medicine

Sergelehskoe highway, 4, Yakutsk, Republic of Sakha (Yakutia), 677010, phone: 8(4112)39–56–69

Russian Federation

Tumen E. Erdyneev

Pediatrician Center of Republican Hospital No. 1, National Center of Medicine

Email: fake@neicon.ru

Pediatric surgeon of the Purulent Surgery Department of Pediatric Center, Republican Hospital № 1, National Centre of Medicine

Sergelehskoe highway, 4, Yakutsk, Republic of Sakha (Yakutia), 677010, phone: 8(4112)39–56–69

Russian Federation

References

  1. Крылов Н. Н., Бабкин О. В., Бабкин Д. О. Мангеймский индекс перитонита - критерий выбора оперативного вмешательства при перфоративной дуоденальной язве. Хирургия. 2016;(7):18-22. doi: 10.17116/hirurgia2016718-22
  2. Linder M. M., Wacha H. The Mannheim peritonitis index. An instrument for the intraoperative prognosis of peritonitis. Chirurg. 1987; 58(2):84-92
  3. Sivaprahasam N., Vijayalakshmi S. Predictive value of mannheim peritonitis index (MPI) for mortality in perforated peptic ulcer. International Journal of Recent Trends in Science And Technology. 2014;12(3):566-8.
  4. Tushar Dani, Ramachandra L., Nair Rajesh, Digvijoy Sharma. Evaluation of prognosis in patients with perforation peritonitis using Mannheim’s peritonitis index. International Journal of Scientific and Research Publications. 2015;(5):2250-3153. http://ijsrp.org/

Copyright (c) 2019 Sleptsov A.A., Savina V.A., Varfolomeev A.R., Nikolaev V.N., Petukhov E.I., Zuev A.L., Erdyneev T.E.

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This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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