Estimation of morphometric indices of parietal peritoneum for prognosis of course of an acute diffuse peritonitis

Keywords: morphometric indices; peritonitis; criteria for prognosis of peritonitis course

Abstract

Objective. To elaborate and estimate the prognostically significant criteria for the inflammatory process course in abdominal cavity in patients, suffering an acute diffuse peritonitis (ADP).

Маterials and methods. Morphological data on parietal peritoneum biopsies were analyzed in 55 patients, suffering ADP of various etiology. There were studied the indices of a neutrophil-polymorphonuclear leukocytes (NPNL), macrophages, lymphocytes, fibroblasts, foci of necrosis, reflecting severity of inflammatory process in parietal peritoneum before and after the operation.

Results. Аnalysis of morphological data on parietal peritoneum biopsies have shown, that in a specific volume of NPNL 0.1314 ± 0.0546, lymphocytes 0.0145 ± 0.0038, macrophages 0.0046 ± 0.0013, fibroblasts 0.1238 ± 0.0203, foci of necrosis 0.0053 ± 0.0016 a prognosis was maximally favorable. If a specific volume NPNL was equal or have exceeded 0.3128 ± 0.0334, lymphocytes - 0.0202 ± 0.0053, macrophages - 0.0049 ± 0.0016, fibroblasts - 0.1192 ± 0.0077, foci of necrosis - 0.0173 ± 0.0046, prognosis was unfavorable. Lethality have constituted 16.3%.

Conclusion. Моrphometric indices of parietal peritoneum, compared with the patients’ state severity, estimated in accordance to the SAPS scale (Simplified acute physiology score - simplified scale for estimation of physiological disorders), оbjectively reflects the ADP course, permits to estimate  the inflammation process severity in abdominal cavity and serve as criteria for the disease course prognostication, permitting to individualize the treatment tactics choice.

Author Biographies

O. V. Selivanova, Bogomolets National Medical University, Kyiv

Selivanova Olga Valentunivna,

MD, PhD, assistant of professor

Department of operative surgery and topography anatomy

Bogomolets national medical university

01601, Kyiv, T. Shevchenko boulevard, 13
Phone (044) 234-40-62.
https://orcid.org/0000-0003-1144-1904

S. S. Selivanov, Bogomolets National Medical University, Kyiv

Selivanov Sergii Sergiiovich

MD, PhD, assistant of professor

Department of operative surgery and topography anatomy

Bogomolets national medical university

01601, Kyiv, T. Shevchenko boulevard, 13
Phone (044) 234-40-62.
https://orcid.org/0000-0002-5280-4233

References

1. Chichom A, Fon TA, Ngowe Ngowe M. Which cause of diffuse peritonitis is the deadliest in the tropics? A retrospective analysis of 305 cases from the South-West Region of Cameroon. World J Emerg Surg. 2016;11:14. Published online 2016 Apr 11. doi: 10.1186/s13017-016-0070-9.
2. Bali RS, Verma S, Agarwal PN, Singh R, Talwar N. Perforation peritonitis and the developing world. ISRN Surg. 2014:105492. doi:10.1155/2014/105492.
3. Ahuja A, Pal R. Prognostic scoring indicator in evaluation of clinical outcome in intestinal perforations. J Clin Diagn Res. 2013;7(9):1953-5. doi: 10.7860/jcdr/2013/6572.3375.
4. Bondarev RV, Selivanov SS. Differencirovannyj podhod k vyboru metoda zavershenija operativnogo vmeshatel'stva pri peritonite. Ukraїns'kij medichnij al'manah. 2010;13(3):29-31. [In Ukrainian].
5. Avtandilov GG. Vvedenie v kolichestvennuyu patologicheskuyu morfologiyu. Moskva: Meditsina; 1980;216 p. [In Russian].
Published
2018-09-30
How to Cite
Selivanova, O. V., & Selivanov, S. S. (2018). Estimation of morphometric indices of parietal peritoneum for prognosis of course of an acute diffuse peritonitis. Klinicheskaia Khirurgiia, 85(9), 54-56. https://doi.org/10.26779/2522-1396.2018.09.54
Section
General Problems of Surgery