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

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.