scholarly journals Comparative analysis of the results of computerized phonoenterography in patients with acute destructive appendicitis before surgery and in the postoperative period

2017 ◽  
Vol 25 (3) ◽  
pp. 469-475
Author(s):  
K. V. Philippova ◽  
O. V. Zaitsev
Keyword(s):  
Abdominal Pain ◽  
Comparative Analysis ◽  
Acute Appendicitis ◽  
Postoperative Period ◽  
Spectral Power ◽  
Abdominal Cavity ◽  
Pain Syndrome ◽  
Acoustic Signals ◽  
Early Postoperative Period ◽  
Control Group

Using the method of computerized phonoenterography we made an analysis of motor-evacuation function of the gastrointestinal tract in 35 patients with acute destructive appendicitis before surgery and in the postoperative period and in 30 patients without abdominal pain syndrome and concomitant pathology of the organs of the abdominal cavity. The obtained results of computerized phonoenterography different in the group of patients with acute appendicitis before appendectomy in comparison with group of patients without acute abdominal pathology (control group). For patients after appendectomy statistically significant differences with the control group in the vast majority of bands wasn’t obtained. Given the fact that the densities of the spectral power of acoustic signals of the abdominal cavity to assess the motor-evacuation function of the intestine in these groups of patients, we showed a reduction of motor-evacuation function of the intestine in patients with acute destructive appendicitis before surgery in comparison with patients of control group and recover in the postoperative period. Thus, the method of computerized phonoenterography is advisable to apply for the diagnosis of lower motor function of the intestine in patients with acute appendicitis, and in the early postoperative period in patients with acute destructive appendicitis for monitoring recovery of intestinal motility.

scholarly journals Mathematical modeling for prediction of complicated acute appendicitis in children

2018 ◽  
Vol 1 (1) ◽  
pp. 70-80
Author(s):  
V. S. Konoplitsky ◽  
V. V. Motygin ◽  
A. G. Yakimenko ◽  
D. V. Dmytriiev ◽  
T. I. Mikhalchuk
Keyword(s):  
Mathematical Model ◽  
Acute Appendicitis ◽  
Postoperative Period ◽  
Abdominal Cavity ◽  
Control Group ◽  
Toxic Substances ◽  
Healthy Children ◽  
Endogenous Intoxication ◽  
Complicated Course ◽  
Complicated Acute Appendicitis

Endogenous intoxication, which accompanies the complicated course of acute appendicitis in children, is one of the serious conditions, which are the main cause of complications in the postoperative period. Diverse clinical observations done by clinicians suggest that despite the use of modern technologies in operating equipment, anesthetic support, the number of complications in the postoperative period has no tendency to decrease, and the main cause of lethal outcomes with appendicular peritonitis is lightning development of severe degree of endotoxicosis, which develops as a result of resorbing toxic substances formed of many components, including pathogenic microflora and destruction metabolism. Purpose. Creation of a mathematical model for prediction of complicated acute appendicitis in children using the functions of regression analysis of EXCEL spreadsheet by approximating experimental data. Materials and methods. In the work, there is information about 59 patients with acute appendicitis treated at the clinic of pediatric surgery at the National Pirogov Memorial Medical University. The data on patients were divided into two groups: patients with not complicated course of pathology – 24 patients, and patients with complicated course of acute appendicitis – 35 children. The control group served the data of 37 healthy children. In each of the three groups, the following parameters were studied: gender, age, bed day, duration of the disease, presence of symptoms of peritoneal irritation, the nature of exudate in the abdominal cavity, the number of red blood cells, hemoglobin, leukocytosis, quantitative characteristics of white blood formula, ESR, cellogenic endogenous intoxication: leukocyte index of intoxication and hematological index of intoxication. All the data were determined directly at the time of hospitalization of a patient to the hospital. Results. Discussion. Based on multiple correlation x = f (x1 , x2 ) a two-factor mathematical model of probability of the complicated course of acute appendicitis in children was created. According to the obtained results of the study of the system of three equations with three unknowns, it was established that if the indicator of the form of the disease is y = 2.67 and above, when, in numerical terms, the result falls into the zone of complicated flow of acute appendicitis and completely coincides with data analysis of the three groups of patients. Conclusions. The components that determine the uncomplicated course of acute appendicitis in children, according to the developed two-factor model, include LII and GPI, which exceed the values intoxication of certain intervals studied at the time of hospitalization. The analyzed indices were determined by the degree of severity of the pathological process, duration of disease, virulence of microflora and age of patients against the background of the formed endogenous intoxication syndrome.

scholarly journals Diagnostics and treatment of abdominal complications after gynecological endoscopic operations

2021 ◽  
Vol 1 ◽  
pp. 75-79
Author(s):  
Yu.P.  Vdovichenko ◽  
V.I.  Boyko ◽  
V.A.  Terehov
Keyword(s):  
Postoperative Complications ◽  
Postoperative Period ◽  
Diagnostic Laparoscopy ◽  
Abdominal Cavity ◽  
Early Postoperative Period ◽  
Main Group ◽  
Laparoscopic Technique ◽  
Control Group ◽  
Diffuse Peritonitis ◽  
Abdominal Complications

The objective: to analyze the results of repeated laparoscopy in gynecological patients with suspected intraperitoneal postoperative complications.Materials and methods. The study involved 42 patients (mean age 46±11,3 years), in whom postoperative abdominal complications after surgical treatment of various gynecological diseases required repeated operations. Depending on the method of re-intervention, the patients were divided into 2 groups: the main group (n=20) – women who only used laparoscopy to correct postoperative complications; control (n=22) – women who were given indications for relaparotomy to correct postoperative complications during diagnostic laparoscopy. Relaparotomy was performed in 8 patients of the control group. All patients underwent a comprehensive examination using clinical, instrumental and laboratory research methods. The groups were homogeneous in terms of age and structure of operations performed on the pelvic organs, and statistically comparable.Results. During the study, the results of repeated laparoscopy of 34 gynecological patients with suspected intraperitoneal postoperative complications were analyzed. In all patients of the main group (47,6%), laparoscopy was revealed as the only and final method of treatment of postoperative complications, while in 7 women repeated relaparoscopy was used from 2 to 4 times, and in 13 women laparoscopy was performed once. In the control group (53,3%), 10 patients during diagnostic laparoscopy were exposed to indications for relaparotomy, in 4 patients the capabilities of the operating team and laparoscopic technique allowed performing some elements of the operation and completing it with a minilaparotomy approach, and 8 patients underwent relaparotomy immediately.Peritonitis and intraperitoneal bleeding prevail in the structure of early abdominal complications. The use of the video laparoscopic technique made it possible in 28,6% of patients with diffuse peritonitis to successfully eliminate the developed complication, eliminate its source and sanitize the abdominal cavity. Laparoscopic hemostasis was successfully performed in 7 patients.Compared with the standard, the use of video endoscopic technique allowed improving the indicators of diagnostic value: to increase the sensitivity level by 1,07 times, specificity by 1,39 times and diagnostic accuracy by 1,11 times.Conclusion. In general, in the early postoperative period, 47 relaparoscopies were performed for suspected complications, which is explained by programmed abdominal sanitization and the use of dynamic laparoscopy to control the course of intraperitoneal complications. Based on the analysis of the material under study, we proposed general indications and contraindications for relaparoscopy in the early postoperative period in order to diagnose and treat postoperative complications. Justifying each of the points, we were guided by the real possibilities of the method in general clinical practice, which in some cases are inferior in their effectiveness to relaparotomy.

scholarly journals Choice of surgical treatment for chronic composite hemorrhoid

2020 ◽  
Vol 39 (3) ◽  
pp. 27-31
Author(s):  
Oleg A. Litvinov ◽  
Evgeniy V. Zhitikhin ◽  
Igor G. Ignatovich ◽  
Hovannes A. Arutyunyan ◽  
Artur G. Arustamov ◽  
...  
Keyword(s):  
Postoperative Period ◽  
Rating Scale ◽  
Stage Iv ◽  
Pain Syndrome ◽  
Numeric Rating Scale ◽  
Early Postoperative Period ◽  
Control Group ◽  
Scientific Center ◽  
Cavernous Tissue ◽  
Numeric Rating

A comparative analysis of the treatment of 142 patients operated on chronic hemorrhoid stage IIIIV has been passed by way of assess the results of using new version of hemorrhoidectomy. The age of patients ranged from 27 to 80 (mean age was 50.46.7). 86 (60.6%) patients were diagnosed with stage III chronic hemorrhoid, at 56 (39.4%) patients the stage IV. For this study patients were divided into basic and controlled groups. The basic group consisted of 73 (51.4%) patients that have had hemorrhoidectomy using our modification. There were 69 (48.6%) patients in control group that have been operated by MilliganMorgan method in second modify of State Scientific Center of Proctology using bipolar coagulator LigaSure. The level of pain was assessed in the early postoperative period by numeric rating scale. The patients had been operated by our method mentioned that the pain syndrome was less pronounced (3.2 against 4.9 balls), that required less painkillers in the early postoperative period. In the case of doing semicircle cuts on the border of anocutaneous crinkle and bringing down mucous membrane, the significant excision of the cavernous tissue doesnt lead to contraction of the anal canal by that reduces the number of functional disorders after hemorrhoidectomy (4 figs, 1 table, bibliography: 7 refs).

scholarly journals The comparative analysis of MRI data in the early period after lumbar microdiscectomies with epidural injection of polyacrylamide hydrogel

2021 ◽  
Vol 27 (2) ◽  
pp. 16-24
Author(s):  
Eugene G. Pedachenko ◽  
Mykhaylo V. Khyzhnyak ◽  
Olena P. Krasylenko ◽  
Yuriy E. Pedachenko ◽  
Olexandr F. Tanaseychuk ◽  
...  
Keyword(s):  
Comparative Analysis ◽  
Postoperative Period ◽  
Early Period ◽  
Epidural Injection ◽  
Early Postoperative Period ◽  
Herniated Disc ◽  
Control Group ◽  
Epidural Administration ◽  
Polyacrylamide Hydrogel ◽  
Spinal Root

Objective: To perform a comparative analysis of MRI data obtained in the early postoperative period after repeated lumbar microdiscectomies in patients with and without epidural injection of “Nubiplant” polyacrylamide hydrogel (HG). Material and methods: The MRI data of the lumbar spine in the early postoperative period after repeated removal of herniated disc (on the 3-15th day) in 84 (100%) patients were analyzed: 30 (35,7%) patients were injected intraoperatively epidurally with “Nubiplant” HG to prevent epidural fibrosis (main group (MG) and in 54 (64,3%) patients the HG was not injected (control group (CG). Results: Comparative analysis of MRI data on the 3-15th day after surgery showed that the frequency of epidural edema and hemorrhage signs within the postoperative area in the MG was significantly lower as compared to the CG (p = 0,0444 and p = 0,0288 respectively). To assess the accuracy of the epidural administration of an artificial biopolymer Nubiplant during lumbar microdiscectomy, in the early postoperative period the following MRI criteria could be helpful: i) absence of the dural sac deformation and dislocations of the spinal root; ii) well-defined margin of the adjacent spinal root; iii) homogeneous MRI signals of the Nubiplant zone; iv) absence of Nubiplant areas outside the postoperative area; v) sufficient sectoral coverage of the adjacent root with epidurally administered Nubiplant (optimally >1800). Nubiplant” HG in the patients of the MG was evaluated, and MRI criteria for assessing the correctness of its introduction were proposed. Conclusions: In the early period after repeated lumbar microdiscectomies (on the 3-15th day), intraoperative epidural injection of “Nubiplant” HG was accompanied by a significant decrease of epidural edema and hemorrhage signs within the postoperative area. The proposed criteria of correctness of HG “Nubiplant” introduction allow unifying the approaches in radiological assessment of this patients.

scholarly journals ASSESSMENT OF THE INTENSITY OF PAIN SYNDROME AND COLLATERAL SWELLING DURING THE SOCKET AUGMENTATION AFTER TOOTH EXTRAXTION WITH DIFFERENT OSTEOPLASTIC MATERIALS

2021 ◽  
Vol 21 (2) ◽  
pp. 97-102
Author(s):  
A. V. Bambuliak ◽  
N. B. Kuzniak ◽  
R. R. Dmytrenko ◽  
S. V. Tkachyk ◽  
V. A. Honcharenko
Keyword(s):  
Comparative Analysis ◽  
Postoperative Period ◽  
Tooth Extraction ◽  
Rating Scale ◽  
Alveolar Bone ◽  
Numerical Rating Scale ◽  
Blood Clot ◽  
Pain Syndrome ◽  
Clinical Effectiveness ◽  
Early Postoperative Period

The article presents a comparative analysis of the clinical effectiveness of osteoplastic materials, in particular a preparation based on multipotent mesenchymal stromal cells of adipose tissue and platelet-enriched plasma used to fill bone defects during the socket augmentation after the tooth extraction. The criteria to assess the therapy effectiveness at the stage of the early postoperative period included the intensity of pain and the amount of collateral oedema after surgery. The aim of this study is to evaluate the clinical effectiveness of osteoplastic materials to augment the volume of the alveolar bone during the operation of socket augmentation after the tooth extraction. Setting of this study: Bukovynian State Medical University, Chernivtsi, Ukraine. The study included 85 patients. The procedure of socket augmentation was performed by using "Kolapan - L" (28.57% of individuals, subgroup A), by combinations of MMSK AT + "Kolapan - L" + PRP (46.43% of individuals, subgroup B); the subgroup C included individuals (25.0%) whose wounds after tooth extraction healed by the formation a blood clot. The assessment of postoperative pain was performed by applying the digital rating scale (Numerical Rating Scale, NRS), taking into account the subjective pain in the patients. The subjects underwent visual assessment of the severity of collateral oedema after the tooth extraction surgery. To determine the dynamics of the severity of oedema we used a scoring system. The study demonstrated the patients of the subgroup B, who received the socket augmentation with "Kolapan - L" + MMSC-AT + PRP, experienced no pain at the final stage of postoperative observation (89.31% of cases) that was 1.2 times higher (p1 <0.05) than in the patients of subgroup A (p> 0, 05). At the final postoperative stages, no collateral oedema was seen in 98.47% of the participants of the subgroups B that exceed the number of cases in the subgroup A where the bone defect was augmented by "Kolapan - L", in 1.2 times (p1 <0.05). A comparative analysis of the clinical effectiveness of osteoplastic materials to increase the volume of the alveolar bone in the jaws during the socket augmentation after the extracted tooth convincingly proved the advantage of using the combination of "Kolapan - L" + MMSС - AT + PRP that was also confirmed by signs and symptoms in the postoperative period.

METHOD OF STOMA FORMATION IN PATIENTS WITH ACUTE INTESTINAL OBSTRUCTION

2021 ◽  
pp. 98-104
Author(s):  
A.L. Charyshkin ◽  
E.A. Keshyan
Keyword(s):  
Intestinal Obstruction ◽  
Postoperative Period ◽  
Comparison Group ◽  
Abdominal Cavity ◽  
Early Postoperative Period ◽  
Main Group ◽  
Acute Intestinal Obstruction ◽  
Control Group ◽  
Drain Tube ◽  
Stoma Formation

Surgery is the main method to treat obstructive intestinal obstruction. Stoma formation is desirable in emergency colon surgery. The aim of the study was to compare the results of the newly developed and traditional stoma formation techniques according to the number of wound purulent-inflammatory complications in the early postoperative period in patients with acute intestinal obstruction. Materials and Methods. The authors examined 62 patients with acute intestinal obstruction. The patients were divided into two groups according to the method of stoma formation. The comparison group consisted of 30 patients, who underwent traditional colostomy after obstructive resection of the sigmoid colon (rectosigmoid part of the colon). The main group included 32 patients in whom a stoma was formed using a newly developed method (patent No. 2704477). In patients of the main group, the paracolostomy space was isolated from the abdominal cavity, the preperitoneal and subgaleurotic zones of the paracolostomy space were drained. During the postoperative period local anesthetics and antibacterial drugs were administered through the drain tube. Results. Patients of the comparison group demonstrated more purulent-inflammatory complications of the median postoperative and paracolostomy wounds than those of the control group, 20.2 % (p=0.047) and 23.6 % (p=0.024), respectively. Conclusion. The proposed method of stoma formation helps to reduce wound purulent-inflammatory complications and can be used in the surgical treatment of patients with intestinal obstruction. Keywords: colon cancer, acute intestinal obstruction, postoperative complications, new method of stoma formation. Основным методом лечения обтурационной кишечной непроходимости является оперативное вмешательство. В экстренной хирургии толстого кишечника показано формирование колостомы. Цель исследования – сравнение результатов применения разработанной и традиционной методик наложения колостомы по количеству раневых гнойно-воспалительных осложнений в раннем послеоперационном периоде у больных с острой обтурационной кишечной непроходимостью. Материалы и методы. Клинический материал составили 62 пациента с острой обтурационной кишечной непроходимостью, которые в зависимости от способа формирования колостомы были разделены на две группы. Группу сравнения составили 30 больных, у которых после обструктивной резекции сигмовидной кишки (ректосигмоидного отдела ободочной кишки) выполняли традиционное наложение колостомы. В основную группу были включены 32 пациента, у которых колостома наложена разработанным способом (патент № 2704477). Суть способа состоит в изоляции от брюшной полости параколостомического пространства, дренировании предбрюшинной и подапоневротической зоны параколостомического пространства, введении местных анестетиков, антибактериальных препаратов по дренажу в послеоперационном периоде. Результаты. В группе сравнения гнойно-воспалительных осложнений срединной послеоперационной и параколостомической ран было больше, чем в контрольной группе, на 20,2 % (р=0,047) и 23,6 % (р=0,024) соответственно. Выводы. Предложенный способ формирования колостомы способствует снижению раневых гнойно-воспалительных осложнений и может быть использован в хирургическом лечении больных с обтурационной кишечной непроходимостью. Ключевые слова: рак ободочной кишки, острая обтурационная кишечная непроходимость, послеоперационные осложнения, оригинальный способ формирования колостомы.

scholarly journals Comparative analysis of the results of cochlear implantation under general and local anesthesiain patients with comorbid pathology

2021 ◽  
Vol 23 (3) ◽  
pp. 250-255
Author(s):  
Khassan M.A. Diab ◽  
◽  
Khassan M.A. Diab ◽  
Nikolai A. Daikhes ◽  
Nikolai A. Daikhes ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Comparative Analysis ◽  
General Anesthesia ◽  
Local Anesthesia ◽  
Postoperative Period ◽  
Cochlear Implantation ◽  
Early Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Fourth Degree

The article is devoted to an urgent problem – the correction of hearing impairment in patients with concomitant diseases. The results of a comparative analysis of data from patients with somatic diseases who underwent cochlear implantation (CI) for severe to profound hearing loss hearing loss of the fourth degree and deafness under local and general anesthesia are presented. Materials and methods. On the basis of the National Medical Research Center for Otorhinolaryngology of the Federal Medical-Biological Agency of Russia, CI was performed under local anesthesia for 10 patients with concomitant diseases, which represented difficulties for the use of general anesthesia (main group). All patients in the preoperative stage precisely informed about each stage of the surgery and with the cue-cards (with questions) to maintain contact with them during CI. The control group consisted of 10 patients who underwent CI under general anesthesia. CI was performed according to a standard technique. After the operation, a survey of patients of both groups about subjective sensations during the operation and in the early postoperative period was carried out. Results. CI under local anesthesia takes an average of 18±5.2 min, taking into account the time of anesthesia, which is 15±5.3 min less than with general anesthesia (p<0.001). When performing CI under local anesthesia, clear thresholds for recording acoustic reflexes stapedial muscle are determined, since in this case the effect of muscle relaxants is excluded. Against the background of local anesthesia, the necessary effect was achieved rather quickly, there was no increase in blood pressure to high numbers, patients answered all the signs and questions by reading the information from the cue-cards. A survey of patients revealed a good tolerance to local anesthesia. The number of patients in the main group which had a complaints in the early postoperative period was less than in the control group (p<0.05). The duration of hospital staying in patients of the main group averaged 1.15 days (from 1 to 3 days), which is significantly less than in the control group – from 3 to 7 days, on average 4.05 days (p<0.05). When conducting CI under local anesthesia, none of the patients showed a destabilization of comorbidity pathology in the postoperative period. Conclusion. CI under local anesthesia in patients with concomitant pathology has several advantages over general anesthesia. The use of local anesthesia will increase the availability of CI for elderly comorbid patients and mitigate the risks of general anesthesia.

scholarly journals Minimum Invasive Stabilizing and Decompressive-Stabilizing Methods of Surgical Treatment for Degenerative-Dystrophic Lesions of Spine

2011 ◽  
Vol 18 (4) ◽  
pp. 3-10
Author(s):  
A V Krut'ko ◽  
Shamil' Al'firovich Akhmet'yanov ◽  
D M Kozlov ◽  
A V Peleganchuk ◽  
A V Bulatov ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Lumbar Spine ◽  
Surgical Techniques ◽  
Pain Syndrome ◽  
Early Postoperative Period ◽  
Main Group ◽  
Control Group ◽  
Surgical Interventions ◽  
Comparative Group ◽  
Operative Wound

Results of randomized prospective study with participation of 94 patients aged from 20 to 70 years with monosegmental lumbar spine lesions are presented. Minimum invasive surgical interventions were performed in 55 patients from the main group. Control group consisted of 39 patients in whom decompressive-stabilizing operations via conventional posteromedian approach with skeletization of posterior segments of vertebral column were performed. Average size of operative wound in open interventions more than 10 times exceeded that size in minimum invasive interventions and made up 484 ± 56 and 36 ± 12 sq.cm, respectively. Mean blood loss was 326.6 ± 278.0 ml in the main group and 855.1 ± 512.0 ml in the comparative one. In the main group no one patient required substitution hemotransfusion, while in 13 patients from the comparative group donor erythrocytic mass and/or fresh-frozen plasma were used to eliminate the deficit of blood components. Intensity of pain syndrome in the zone of surgical intervention by visual analog scale in the main group was lower than in comparative group. In the main and comparative groups the duration of hospitalization made up 6.1 ± 2.7 and 9.7 ± 3.7 bed days, respectively. In no one patient from the main group complications in the zone of operative wound were noted. Three patients from the comparative group required secondary debridement and in 1 patient early deep operative wound suppuration was observed. Application of low invasive surgical techniques for the treatment of patients with degenerative lumbar spine lesions enabled to perform radical surgical treatment with minimal iatrogenic injury. The method possessed indubitable advantages over the conventional open operations especially intraoperatively and in early postoperative period.

scholarly journals Changes in Indicators of Microcirculation in the Early Postoperative Period in the Treatment of Diaphyseal Fractures of the Shin Bones Using a Plate with Limited Contact

2019 ◽  
Vol 4 (3) ◽  
pp. 58-62
Author(s):  
A. I. Plakhov ◽  
L. I. Kolesnikova ◽  
L. I. Korytov ◽  
V. G. Vinogradov ◽  
M. A. Darenskaya
Keyword(s):  
Postoperative Period ◽  
Lower Limb ◽  
Blood Circulation ◽  
Early Period ◽  
Metal Plate ◽  
Early Postoperative Period ◽  
Control Group ◽  
Doppler Flowmetry ◽  
Results Of Treatment ◽  
Diaphyseal Fractures

Background. Unsatisfactory results of treatment, such as delayed consolidation and non-fusion of fractures, the formation of false joints and limb bone defects, have no tendency to decrease. We can assume that one of the leading factors of complications in traumatology is a violation of microcirculation in the affected segment of the limb.Aims. To identify patterns of changes in the parameters of the microcirculatory bed of the damaged segment of the lower limb when fixing bone fragments with a plate with limited contact in the early period after surgery.Materials and methods. In 25 patients, we studied four parameters of microcirculation of the lower limb segment with application of laser Doppler flowmetry. The control group consisted of 25 healthy volunteers, comparable in age and sex with the study group.Results. We found that in the early postoperative period (from the first to the 10th day after the surgery) in patients with diaphyseal fractures of the tibia operated with metal plate with limited contact there was an increase in microcirculation by 75.69 %, an increase in the proportion of the nutritive component of microcirculation compared to the shunt fraction by 24.64 %, as well as an increase in more than one ratio of the amplitude of the heart and respiratory range. All of that indicates a local circulatory disorder in the nutritive arterial hyperemia. We note that the increase in the amplitude of the respiratory component by 17.22 % and the equality of the amplitude of the cardiac range compared with the control group indicate violations of local blood circulation by the type of venous stagnation.Conclusion. On the basis of the results obtained, we note that patients with diaphyseal fractures of the shin bones treated with metal osteosynthesis with a plate with limited contact in the early postoperative period develop a violation of local blood circulation in the stagnant-hyperemic type.

scholarly journals THE COMPARATIVE ANALYSIS OF ALVARADO AND PAS SCALES IN THE DIFFERENTIAL DIAGNOSTICS OF ACUTE ABDOMINAL PAIN IN CHILDREN

2020 ◽  
Vol 23 (6) ◽  
pp. 309-313
Author(s):  
Viktor G. Vakulchyk
Keyword(s):  
Clinical Trial ◽  
Abdominal Pain ◽  
Comparative Analysis ◽  
Acute Appendicitis ◽  
Diagnostic Accuracy ◽  
Acute Abdominal Pain ◽  
Differential Diagnostics ◽  
Current Trends

Introduction. Current trends in the diagnostics of acute appendicitis have the following main objectives: to improve the diagnostic accuracy in destructive forms; to reduce the number of negative appendectomies and diagnostic laparoscopies. Purpose. To compare the effectiveness of Alvarado and PAS scales and to find out which of them is more appropriate in the differential diagnostics of acute abdominal pain in children. Material and Methods. A prospective randomized blind clinical trial was performed. 326 children aged 5-17 years with abdominal pain were examined. Results. No significant advantages of any of the analyzed scales were found in the differential diagnostics of acute abdominal pain in children aged 5-17 years. Both scales can be used in the primary stratification of patients. With the conclusion “Acute appendicitis is likely possible,” the level of non-diagnosed cases of acute appendicitis will not exceed 3%. Conclusions. Further assessment of various scales for the diagnostics of acute appendicitis in children has to be done in order to select the optimal one. The obtained results urge to make scales’ modification so as to improve the diagnostic accuracy and to reduce the number of negative appendectomies and diagnostic laparoscopies.

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