Causes of unsatisfactory results of diagnostics of peritonitis at the prehospital stage

Bilyayeva О.О.,Kryzhevsky V.V.,Karol І.V.

Головна
Публікації
Causes of unsatisfactory results of diagnostics of peritonitis at the prehospital stage

26 серпня 2021

1073

Ключові слова :

endogenous intoxication,

multiorgan failure,

peritonitis

Спеціальності :

Surgery

Резюме

The aim was study of the causes of unsatisfactory results of peritonitis diagnostics at the prehospital stage.

Matherials and methods. The study included 265 patients with peritonitis of various origins, who were treated in 2020 in the surgical department of Brovary Multidisciplinary Clinical Hospital, among them there were 124 (46.8%) females and 141 (53.2%) males.

Results. After 24 hours from the onset of the first symptoms of the disease, 87 (32.8%) patients were hospitalized. Of these, in 49 (56.3%) cases there was local, in 28 (32.2%) — diffuse, in 7 (8.0%) patients — diffuse, and in 3 (3.5%) cases — general peritonitis. At late hospitalization of patients the character of exudate in an abdominal cavity at peritonitis was serous in 12 (13.8%), serous-fibrinous — in 19 (21.8%), fibrinous-purulent — in 11 (12.6%), purulent — in 39 (44.8%), fecal — in 1 (1.2%), hemorrhagic — in 3 (3.5%) and bile — in 2 (2.3%) cases.

Conclusions. The most important reason for unsatisfactory results of diagnosis and treatment of peritonitis is late treatment, which is a consequence of self-medication or referral to specialists in alternative medicine. Of the 87 cases of late hospitalization of patients with peritonitis in 64 (73.6%) cases the cause was self-medication, in 7 (8.0%) — alternative medicine, in 16 (18.4%) — errors of nurses as in prehospital, and in the hospital stages.

References:

1. Lenik R.H., Savytskyi I.V. et al. (2019) Doslidzhennia dynamiky leikotsytarnoho ta erytrotsytarnoho indeksiv intoksykatsii v patohenezi eksperymentalnoho perytonitu. Ukr. Zhurn. Med. Biol. Sport., 4(5): 57–61. doi: 10.26693/jmbs04.05.057. [In Ukr.].
2. Kumar S., Kumar S., Kumar S., Gautam S. (2015) Spontaneous gallbladder perforation in a patient of situs inversus totalis, misdiagnosed as perforation peritonitis due to gas under the right dome of the diaphragm. BMJ Case Rep.: 1–3. doi: 10.1136/bcr-2014-208003.
3. Kim T., Hong S.I., Park S.Y. et al. (2016) Clinical Features and Outcomes of Spontaneous Bacterial Peritonitis Caused by Streptococcus pneumoniae: A Matched Case-Control Study. Medicine (Baltimore), 95(22): e3796. doi: 10.1097/MD.0000000000003796.
4. Dzyubanovskyi I.Ya., Vervega B.M., Pidruchna S.R., Melnyk N.A. (2018) Osoblyvosti stanu prooksydantnoyi systemy pry eksperymentalnomu perytoniti na tli czukrovogo diabetu. Med. Klin. Khim., 20(4): 66–71. doi: 10.11603/mcch.2410-681X.2018.v0.i4.9799. [In Ukr.].
5. Beljaeva O.A. (1999) Kompleksnoe lechenie peritonita i profilaktika ego oslozhnenij (jeksperimental’no-klinicheskoe issledovanie). Kiev, 375 p. [In Rus.].
6. Duzhyi I.D., Kravets O.V., Piatykop H.I. et al. (2013) Dynamika kliniko-laboratornykh pokaznykiv endohennoi intoksykatsii u khvorykh z poshyrenym perytonitom. Aktualni problemy suchasnoi medytsyny: Visn. Ukr. Med. Stomat. Akad., 13(1): 93–95. [In Ukr.].
7. Pavlovskyi M.P. (2003) Rol i mistse miniinvazyvnykh tekhnolohii u likuvanni perytonitu ta yoho septychnykh uskladnen. Klin. Khir., 4–5: 29. [In Ukr.].
8. Tomnyuk N.D., Danilina E.P., Chernyih A.N. et al. (2010) Peritonit, kak odna iz osnovnyih prichin letalnyih ishodov. Sovremennyie naukoemkie tehnologii, 10: 81–84. [In Rus.].
9. Sergienko V.I., Petrosyan E.A., Tereshchenko O.A. et al. (2012) Endotelialnaya disfunkciya i metody ee korrekcii pri eksperimentalnom zhelchnom peritonite. Khirurgiya. Zhurnal im. N.I. Pirogova, 3: 54–58. [In Rus.].
10. Hrynchuk A.F. (2017) Dyferentsiina diahnostyka hostroi patolohii u nevidkladnii abdominalnii khirurhii. Klinichna anatomiia ta operatyvna khirurhiia, 16(3): 29–31. DOI: 10.24061/1727-0847.16.3.2017.75. [In Ukr.].
11. Moore L.J., Todd S.R. (2017) Common Problems in Acute Care Surgery. Springer Int. Publ., 507 p.
12. Biliaieva O.O., Karоl I.V. (2020) Doslidzhennia zmin funktsionalnoho stanu sertsevo-sudynnoi systemy u khvorykh iz perytonitom. Klinichna khirurhiia, 87(11–12): 23–27. DOI: 10.26779/2522-1396.2020.11-12.23. [In Ukr.].
13. Zdzitovetskiy D.E., Borisov R.N. (2012) Analiz chastotyi raspostranYonnogo peritonita i rezultatov ego lecheniya v mnogoprofilnom statsionare. Sovremennyie problemyi nauki i obrazovaniya. [In Rus.].