The features of the early postoperative period in pelviperitonitis

Abstract

Background. Treatment of patients with acute peritonitis, including pelvic, is still one of the actual questions, due to the persisting negative results. This is mainly due to unclear understanding of the pathogenesis of the disease and the early postoperative period. In-depth knowledge of this issue will form the basis for the development of optimal therapy regimens. The purpose of this work is to determine the features of the early postoperative period in patients with acute pelvic peritonitis. Materials and methods. The work is based on the materials of clinical and laboratory studies of 42 patients with acute peritonitis of different genesis: group 1 – acute pelvic peritonitis (19); group 2 – acute peritonitis of appendicular origin (23). The patients were examined at admission and in the early postoperative period. The diagnostic complex, along with routine investigations, includes: assessment of the endogenous intoxication syndrome, oxidative stress and phospholipase activity; a number of indicators of the functional status of the intestine and liver. Results. It is established that before the operation and in the early postoperative period in patients with acute peritonitis there are markable phenomena of endogenous intoxication, oxidative stress with the decline of antioxidant enzyme capacity and activation of phospholipases, which are associated with impaired functional state of the intestine and liver. The severity and dynamics of these changes is associated with the origin of peritonitis. In acute pelviperitonitis against the background of an accelerated recovery of functional state of the intestine and liver, disorders of homeostasis in the early postoperative period are corrected faster, the course of the early postoperative period proceeds favorably with minimal postoperative complications. Conclusions. In acute purulent pelvic peritonitis, in contrast to appendicular peritonitis, there is a relatively positive course of the early postoperative period and a decrease in the development of complications, which is associated with mild endogenous intoxication symptoms against the background of an accelerated recovery of intestinal and liver function.

Keywords

• peritonitis
• endogenous intoxication
• lipid peroxidation
• intestines
• liver