Treatment of purulent peritonitis

1927 ◽  
Vol 23 (5) ◽  
pp. 586-587
Author(s):  
A. Timofeev
Keyword(s):  
Intravenous Injection ◽  
Abdominal Cavity ◽  
Early Operation ◽  
Sugar Solution ◽  
Infectious Focus ◽  
Purulent Peritonitis

The author treats purulent peritonitis as follows: early operation is possible, and, if circumstances permit, it is useful to pre-prepare the patient with napertia, coffein, and intravenous injection of 20 cc. 40% grape sugar solution to reduce the danger of anesthesia to the heart; the site of the incision is chosen according to the localization of the process; the wound is lubricated with Peruvian balsam before opening the peritoneum; if peritonitis spills over, the abdominal cavity is flushed; if the infectious focus can be reliably turned off, drainage is not necessary; wire sutures. Careful stretching of rectal stomas after surgery facilitates the evacuation of gases and feces.

To the treatment of gastric ulcers

1927 ◽  
Vol 23 (9) ◽  
pp. 965-965
Author(s):  
E. Board
Keyword(s):  
Intravenous Injection ◽  
Intestinal Tract ◽  
Gastric Ulcers ◽  
Sugar Solution ◽  
Rapid Healing

A prerequisite for rapid healing of gastric ulcers is complete rest for both the stomach itself and the upper intestinal tract. To achieve this, Tillmann recommends feeding the patient exclusively by intravenous injection of grape sugar solution (5.00 per 1000.0 saline) for 10-12 days.

Treatment of purulent diffuse peritonitis

1927 ◽  
Vol 23 (3) ◽  
pp. 351-352
Author(s):  
A. Timofeev
Keyword(s):  
Abdominal Cavity ◽  
Harmful Effect ◽  
Diffuse Peritonitis ◽  
Infectious Focus ◽  
Perforative Peritonitis

The author reports that in Petrivalskis' clinic in the treatment of diffuse perforative peritonitis drainage is not used if the infectious focus is removed; abscesses are drained; antiseptics are also not used due to their harmful effect on the vital properties of the peritoneal endothelium, but it is recommended to infuse 50-100 cc into the abdominal cavity. 3% solution of hydrogenii superoxydati, and the resulting foam mechanically cleans the abdominal cavity, and the released oxygen produces oxidation of toxins.

scholarly journals Results Of Treatment Of Acute Diffuse Purulent Peritonitis Using Laparostomy

2020 ◽  
Vol 02 (11) ◽  
pp. 66-71
Author(s):  
S. A. Ruziboev ◽  
◽  
A. A. Avazov ◽  
Sh. Kh. Sattarov ◽  
A. N. Elmuradov ◽  
...  
Keyword(s):  
Bacterial Translocation ◽  
Abdominal Cavity ◽  
Multiple Organ ◽  
The Body ◽  
Abdominal Pressure ◽  
Results Of Treatment ◽  
Abdominal Hypertension ◽  
Purulent Peritonitis ◽  
Intractable Problems ◽  
Cause Of Deaths

Currently, despite significant achievements in the field of surgery, anesthesiology and resuscitation, the results of treatment of patients with advanced purulent peritonitis remain one of the most intractable problems, almost every sixth patient with acute surgical diseases and injuries of the abdominal cavity is admitted to medical institutions with peritonitis [1,3] Common peritonitis in 17-29% complicates the course of most acute surgical diseases and is the main cause of deaths in surgical hospitals [3,7]. Lethality in advanced peritonitis remains extremely high and reaches 20-39% [1,2,4,5]. In recent decades, great importance has been attached to recording intra-abdominal pressure in purulent pathology of the abdominal cavity. It was found that intra-abdominal hypertension occurs in every third patient with acute surgical pathology and negatively affects the functioning of all organs and systems of the body [1,6,8]. Pathological changes that occur with acute and excessive increase in intra-abdominal pressure (IAP) are manifestations of abdominal compartment syndrome (ACS) with disorders of the cardiovascular system; urinary disorders, disorders of perfusion of internal organs and the development of intestinal ischemia, which contributes to bacterial translocation and endogenous infection [2,7,8]. Ischemic blood flow disorders of the splanchnic zone are fraught with the development of bacterial translocation and the development of systemic inflammatory response syndrome and multiple organ failure (PON). Unsatisfactoriness with such results gave rise to a fundamentally different approach to the surgical treatment of common forms of peritonitis-the introduction of an open abdominal management method based on the ideas of I. Mikulich (1881), Jean-Louis Faure (1928), N. S. Makoch (1984) and D. Steinberg (1979).

scholarly journals SUCCESSFUL TREATMENT OF SEVERE PURULENT PERITONITIS WITH INTRAABDOMINAL HYPERTENSION COMPLICATIONS (CLINICAL CASE)

2021 ◽  
pp. 62-65
Author(s):  
V. V. Grubnik ◽  
Е. А. Koychev ◽  
V.M. Kosovan ◽  
M. M. Chernov
Keyword(s):  
Traditional Method ◽  
Clinical Case ◽  
Open Abdomen ◽  
Abdominal Cavity ◽  
Integrated Approach ◽  
Vac Therapy ◽  
New Methods ◽  
Purulent Peritonitis ◽  
Intraabdominal Hypertension ◽  
Abdominal Compartment

The widely used traditional method of surgical treatment of patients with widespread purulent peritonitis failed to establish itself as universal and has a large number of disadvantages, which prompts the use of new methods of managing patients in the postoperative period in surgical practice. The case described in the work illustrates the possibilities of a successful integrated approach in the treatment of diffuse purulent peritonitis against the background of Abdominal Compartment Syndrome, which includes the «Open abdomen» and «VAC-therapy» techniques, the use of which leads to a persistent decrease in both IАP and relief of the phenomena of purulent inflammation in the abdominal cavity. Conclusions. The use of VAC-therapy in combination with the «Open abdomen» technique leads to a persistent decrease in both ICP and relief of the phenomena of purulent inflammation in the abdominal cavity.

scholarly journals The acute peritonitis treatment optimizing in early postoperative period

2021 ◽  
Vol 179 (5) ◽  
pp. 57-62
Author(s):  
E. K. Dzidzava ◽  
A. P. Vlasov ◽  
O. V. Markin ◽  
I. V. Fedoseykin ◽  
I. V. Gluchova ◽  
...  
Keyword(s):  
Functional Status ◽  
Treatment Regimen ◽  
Abdominal Cavity ◽  
Laboratory Data ◽  
Blood Parameters ◽  
Early Postoperative Period ◽  
Control Group ◽  
Acute Peritonitis ◽  
Endogenous Intoxication ◽  
Purulent Peritonitis

The Objective was to evaluate the effectiveness of original physiotherapeutic methods in the treatment of patients with acute spread purulent peritonitis.Methods and Materials. We done a treatment approach analysis of 72 patients with peritonitis after programmed sanitation of the abdominal cavity. The control group included 42 patients with standardized treatment regimen. The main group consisted of 35 patients. Their treatment included low-intensity laser radiation of the abdominal cavity, electrical stimulation of the duodenum according to the original methods. We evaluated dynamic changes of the blood parameters, endogenous intoxication markers, the functional status of the liver, kidneys, and intestines.Results. The use of original physiotherapeutic methods in the treatment of patients with acute peritonitis leads to a significant improvement in clinical and laboratory data. The functional status of the liver, kidneys and intestine restored rapidly. Mortality rate decreased from 28.7 to 17.1 % (χ2=1.392, p=0.238), hospital stay decreased by 5.7 hospital days (p<0.05).Conclusion. The treatment regimen for severe peritonitis leads to a relatively rapid relief of the inflammatory process in the abdominal cavity, as well as the restoration of the functional status of the liver, kidneys and intestine. It largely determines the correction of homeostatic indicators, including reducing the severity of endogenous intoxication. 

scholarly journals SANITATION OF THE ABDOMINAL CAVITY IN WIDESPREAD PERITONITIS

2020 ◽  
pp. 37-42
Author(s):  
V. N. Lykhman ◽  
A. N. Shevchenko ◽  
A. O. Merkulov ◽  
D. A. Myroshnychenko ◽  
S. V. Tkach ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Postoperative Period ◽  
Absolute Risk ◽  
Multiorgan Failure ◽  
Abdominal Cavity ◽  
Average Degree ◽  
Average Weight ◽  
Results Of Treatment ◽  
Dialysis Solution ◽  
Purulent Peritonitis

Summary. Purpose. Study of the effectiveness of permanent transmembrane peritoneal dialysis in “semi-closed” management of the abdominal cavity (BP) in patients with advanced purulent peritonitis (APP). Materials and methods. The results of treatment of 63 patients with APP with “semi-closed” administration in the abdominal cavity (BP) were analyzed. Depending on the features of BP drainage, patients with RGP were divided into two groups: comparison group (CG) — 31 patients who used traditional methods of abdominal drainage and the main group (MG) — 32 patients who underwent permanent peritoneal surgery in the postoperative period. dialysis through an artificial semipermeable membrane. Results and discussion. A study of the relationship between the levels of molecules of average weight in spent dialysis solution with the severity of multiorgan failure (MF) on the SOFA scale using Spearman’s correlation analysis revealed an average degree of correlation: 1 day after surgery - r = 0.63 (p = 0.01), for 3 days — r = 0.75 (p = 0.001). The average degree of correlation between these indicators can be explained by the fact that in addition to endotoxicosis, the severity of MF in the next day after surgery also affects surgery. This is also confirmed by the increase in the correlation coefficient by 3 days, when the degree of influence of the operating aid on the severity of MF decreases. The postoperative period was complicated in 14 (22.2 ± 5.2 %) patients with APP: in CG in 10 (32.3 ± 8.4 %) cases in MG - in 4 (12.5 ± 5.8 %) p = 0.059). Mortality of patients with APP at “semi-closed” management of an abdominal cavity made 19,0 ± 4,9 %: in MG — (25,8 ± 7,9) %, in MG — (12,5 ± 5,8) % (p = 0,179). Conclusions. The proposed method of peritoneal dialysis reduced the absolute risk of postoperative complications in patients with advanced purulent peritonitis by 19.8 %.

scholarly journals Experimental Modeling of General Purulent Peritonitis

2019 ◽  
Vol 4 (3) ◽  
pp. 117-121
Author(s):  
E. E. Chepurnykh ◽  
I. A. Shurygina ◽  
T. V. Fadeeva ◽  
E. G. Grigoryev
Keyword(s):  
Abdominal Cavity ◽  
Clinical Manifestations ◽  
Coli Strain ◽  
Male Rats ◽  
Morphological Data ◽  
E Coli ◽  
Morphological Studies ◽  
General Peritonitis ◽  
Purulent Peritonitis ◽  
Treatment Mortality

General purulent peritonitis takes one of the first places in the structure of purulent complications. Despite the im provement of methods of diagnosis and treatment, mortality in postoperative purulent peritonitis remains quite high.Aim of the study: develop a reproducible model of postoperative general peritonitis to study the pathophysiological mechanisms of its development and the development of pathogenetically substantiated therapy.Materials and methods. The study was performed on 18 Wistar male rats aged 6 months, weighing 250–300 grams. Animals underwent laparotomy and modeling of postoperative general peritonitis according to the proposed method. Hospital strains of Escherichia coli BRLS 109 and Bacteroides fragilis 109 (strain ISCST1982, registered in Genbank), which we isolated from patients with acute appendicitis, with a total volume of 1.0 ml per animal, were used as infectious agents. Animals were taken out of the experiment under anesthesia with compliance with the rules of euthanasia at 1st, 3rd, 7th days after surgery. For morphological studies, samples of a fragment of the abdominal wall and cecum were taken. Bacteriological studies were performed on the 3rd, 7th day from the beginning of the experiment.Results. It was established that all animals developed peritonitis with the progression of purulent-destructive changes in the abdominal cavity and the development of adhesions, which was confirmed by the data of the morphological method of research. According to the results of bacteriological studies on the 3rd day, exudate infection was detected in all rats (in 100 % of observations). E. coli BLS were isolated in all cases at concentrations of 103–104 CFU/ml. The strain B. fragilis is inoculated in 3 animals at a concentration of 103 CFU/ml, which made 50 %. By the 7th day, only an aerobic E. coli strain of BLS was detected in peritoneal exudate at concentrations of 103 CFU/ml in the complete absence of growth of B. fragilis.Conclusion. We have developed a model of postoperative general peritonitis, which allows us to study the dynamics of the development of the inflammatory process in the abdominal cavity and, in terms of its clinical manifestations, is close to a real human disease. The reproducibility of the model is 100 %, which is confirmed by microbiological and morphological data.

scholarly journals Impact of the SARS-CoV-2 pandemic on the course and treatment of appendicitis in the pediatric population

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Alicja Pawelczyk ◽  
Malgorzata Kowalska ◽  
Marzena Tylicka ◽  
Olga Martyna Koper-Lenkiewicz ◽  
Marta Diana Komarowska ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Abdominal Cavity ◽  
Open Appendectomy ◽  
Laparoscopic Approach ◽  
World Health ◽  
Major Influence ◽  
Significant Difference ◽  
Purulent Peritonitis ◽  
Care System

AbstractSARS-CoV-2 is a highly contagious virus causing mainly respiratory track disease called COVID-19, which dissemination in the whole world in the 2020 has resulted in World Health Organisation (WHO) announcing the pandemic. As a consequence Polish Government made a decision to go into a lockdown in order to secure the population against SARS-CoV-2 outbreak what had its major influence on the Polish Health Care System. All of the social and medical factors caused by the pandemic might influence children’s health care, including urgent cases. The aim of this survey was the analysis of medical charts with focus on the course and results of surgical treatment of children who underwent appendectomy before and during the COVID-19 pandemic. Material and methods: We performed analysis of charts of 365 subjects hospitalized in the Pediatric Surgery Department from 1st January 2019 to 31st December 2020 because of acute appendicitis. Patients were divided into two groups—those treated in 2019—before pandemic outbreak, and those treated in 2020 in the course of pandemic. Results: the most common type of appendicitis was phlegmonous (61% of cases in 2019 and 51% of cases in 2020). Followed by diffuse purulent peritonitis (18% of cases in 2019 vs 31% of cases in 2020), gangrenous (19% of cases in 2019 vs 15% of cases in 2020) and simple superficial appendicitis (1% of cases in 2019 vs 3% of cases in 2020). There was statistically significant difference in the length of hospitalization: in 2019 the mean length of hospi-talization was 4.761 vs 5.634 in 2020. Laparoscopic appendectomy was performed more frequently before the COVID period (63% of cases treated in 2019 vs 61% of cases treated in 2020). In the pandemic year 2020, there was double increase in the number of conversion from the laparoscopic approach to the classic open surgery. In the year 2019 drainage of abdominal cavity was necessary in 22% of patients treated with appendectomy, in 2020 the amount of cases threated with appendectomy and drainage increased to 32%. Conclusions: fear of being infected, the limited availability of appointments at General Practitioners and the new organisation of the medical health care system during pandemic, delay proper diagnosis of appendicitis. Forementioned delay leads to higher number of complicated cases treated with open appendectomy and drainage of abdominal cavity, higher number of conversions from the laparoscopic to classic open technique, and longer hospitalization of children treated with appendectomy in the year of pandemic.

scholarly journals Особливості імунного профілю у крові щурів з гострим поширеним перитонітом на тлі гіпотиреозу

2018 ◽  
Author(s):  
R. V. Verba ◽  
I. M. Klishch
Keyword(s):  
Immune System ◽  
B Lymphocytes ◽  
Wistar Rats ◽  
Abdominal Cavity ◽  
Pathological Process ◽  
Immune Defense ◽  
Fecal Suspension ◽  
Purulent Peritonitis ◽  
Negative Effect ◽  
Cd4 Lymphocytes

Introduction. Peritonitis remains one of the most common complications of surgical diseases of the abdominal cavity [5, 11]. According to individual authors, in severe forms of disseminated purulent peritonitis, the mortality reaches 50–80 % [3, 13, 15]. All this points to the need for further improvement of the methods of diagnosis and treatment of this pathological process.The aim of the study – establishment of features of the immune system cellular and humoral units functioning in rats with acute widespread peritonitis on the background of experimental hypothyroidism.Materials and Methods. White Wistar rats were used in the work. Hypothyroidism was modeled by the administration of Mercazolil at a dose of 25 mg / kg for 21 days. Acute common peritonitis was modeled by injecting 0.5 ml of 10 % filtered fecal suspension into the abdominal cavity of the animals under study. Cellular (CD4+, CD8+, CD22+-lymphocyte) and humoral (IgA, IgM, IgG) immunity were measured. The animals were decapitated under thiopental anesthesia after 24 hours, on the 4th, 7th and 10th days from the beginning of peritonitis modeling.Results and Discussion. It was found that in animals with acute widespread peritonitis against hypothyroidism, there is a significant decrease in CD4+ lymphocytes, a violation of the ratio of the main subpopulations of lymphocytes (CD4+ and CD8+), which is accompanied by a significant decrease in the immunoregulatory index. The dynamics of changes in B-lymphocytes CD22+, which are producers of immunoglobulins, was indicative. These changes correlated with the state of specific humoral immunity – the concentration of immunoglobulins in the serum of the corresponding groups of animals.When simulating common peritonitis, euthyroid animals showed a decrease in IgG concentration and an increase in IgM and IgA. Against the background of hypothyroidism, we noted a decrease in the level of immunoglobulins of all classes after 24 hours of the duration of the pathological process with a further decrease to the tenth day. The indices of all classes of immunoglobulins were also significantly lower than those of euthyroid animals with acute widespread peritonitis.Conclusions. In animals with acute common peritonitis, hypothyroidism is significantly reduced CD4+ lymphocytes, a violation of the ratio of the main subpopulations of lymphocytes (CD4+ and CD8+), which is accompanied by a significant decrease in the immunoregulatory index. The insufficiency of the cellular part of the immune response was found to reflect an increase in the mutual negative effect of the inflammatory process in the peritoneum and systemic disorders of immune defense in conditions of concomitant hypothyroidism. There is a direct relationship between the reduced level of CD22+ lymphocytes and the indices of immunoglobulins of classes A and G.In acute widespread peritonitis against the background of mercazolil-induced hypothyroidism, there is a violation of the functionality of the immune system, manifested by an imbalance of immunoglobulins in the bloodstream and a decrease in the resistance of the humoral link of the immune system.

scholarly journals Diagnosis and treatment of destructive forms of acute pancreatitis

2019 ◽  
Vol 41 part 1 (2) ◽  
pp. 65-70
Author(s):  
V. V. Mishchenko ◽  
V. V. Hrubnyk ◽  
P. I. Pustovoyt ◽  
V. V. Horyachyy ◽  
V. V. Velychko ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Cavity ◽  
Secretory Activity ◽  
Multiple Organ ◽  
Diagnosis And Treatment ◽  
Infusion Therapy ◽  
Surgical Interventions ◽  
Purulent Peritonitis ◽  
Peridural Anesthesia ◽  
Complete Cell

Purpose of the study. The study of the diagnosis and treatment of destructive forms of acute pancreatitis and the identification of possible ways to optimize them. Materials and methods. Destructive forms of acute pancreatitis were found in 16,8%. The algorithm for treating acute destructive pancreatitis consisted in artificial ventilation of the lungs, adequate infusion therapy, peridural anesthesia, setting up a nasoenteric probe, stimulating the bowels, correcting hemodynamics, intra- and extracorporal detoxification, antisecretory, anti-bacterial, hepatoprotective, cerebroprotective, antioxidant therapy, directed immune correction, use of anti-enzyme drugs, suppression of the release of mediators inflammation, external secretory activity of the pancreas. Medical video laparoscopy and puncture interventions under the control of ultrasound were used as the first stage of surgical treatment. The indications for traditional surgical interventions are large areas of aseptic destruction, unlimited infected pancreatic necrosis, infection of necrotic areas with complete cell sequestration, abscesses with large sequesters, abdominal phlegmon, signs of progressive multiple organ failure and the development of arousal hemorrhage, perforation of cystic formations in the abdominal cavity, perforation of a hollow organ, purulent peritonitis. Results. The developed therapeutic tactics allowed, in destructive forms of acute pancreatitis, to achieve a reduction in overall mortality to 23,4%. Conclusion. Diagnostic and treatment tactics for destructive forms of acute pancreatitis should be standardized depending on the timing, severity of the disease, localization and prevalence of the destructive process, systemic and local complications. Keywords: acute, destructive, pancreatitis, diagnosis, treatment.

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