Year 2011 Vol. 19 No 4

GENERAL AND SPECIAL SURGERY

K.N. BARSUKOV, G.P. RYCHAGOV

ABSCESSES OF THE ABDOMINAL CAVITY AS A CAUSE OF POSTOPERATIVE PERITONITIS

Objectives. To study the regularities of intra-abdominal abscesses, peculiarities of their diagnostic and treatment strategies.
Methods. The retrospective analysis of the treatment results of more than 40000 patients during the period of 2003-2008 in 5 different hospitals was carried out. 104 cases of the postoperative abscesses development were revealed.
Results. Abscesses of the abdominal cavity in 28,5% are the cause of relaparotomy, in 82% they occur after an urgent surgery. In 68,2% they are diagnosed on the 6-9 days. To eliminate complications in 70% a patient underwent one relaparotomy; in 18% – two relaparotomies; in 7,6% – three; in 5% – four. In 36 (35%) cases relaparotomy was performed from the access directly over the focus and in 68 (65%) – from the median access. In 68 (65%) microflora was represented by aerobic-anaerobic associations; in 24% – by anaerobic monoinfection. The lethal outcome was registered in 17 (16,3%) cases.
Conclusions. Timely diagnostics of postoperative abcesses still remains rather problematic and not always a soluble problem. The most frequent nosology at which abscesses develop is a closed abdominal trauma – 5,9%, a complicated colon cancer – 2,8%, acute pancreatitis – 2,3%.

Keywords: intraabdominal abscesses, relaparotomy, postoperative peritonitis
p. 71 – 76 of the original issue
References
  1. Зубков, М. Н. Современные аспекты антимикробной терапии смешанных анаэробно-аэробных инфекций в абдоминальной хирургии / М. Н. Зубков // Фарматека. Хирургия. – 2010. – №16 (111). – С. 9-14.
  2. Kpигep, A. Г. Диагностика и лечение послеоперационных внутрибрюшных осложнений / A. Г. Kpигep, Б. K. Шуpкaлин, П. С. Глушков // Хирургия. Журн. им. Н. И. Пирогова. – 2003. – № 8. – С. 21-27.
  3. Динамика инфекционного процесса при интраабдоминальных абсцессах у больных с перитонитом / А. В. Леванов [и др.] // Медицина в Кузбассе. – 2005. – № 3. – С. 49-51.
  4. Карасева, О. В. Лапароскопические операции при абсцедирующих формах аппендикулярного перитонита у детей / О. В. Карасева, В. А. Капустин, А. В. Брянцев // Дет. хирургия. – 2007. – № 3. – С. 23-27.
  5. Гельфанд, Б. Р. Антибактериальная терапия хирургической абдоминальной инфекции и абдоминального сепсиса / Б. Р. Гельфанд, В. А. Гологорский, С. З. Бурневич // Consilium medicum. – 2000. – Т. 2, № 9. – С. 36-44.
  6. McCann, J. W. Image-guided drainage of multiple intraabdominal abscesses in children with perforated appendicitis: an alternative to laparotomy / J. W. McCann, S. Maroo // Pediatr. Radiol. – 2008. – N 38. – Р. 661-668.
Contacts | ©Vitebsk State Medical University, 2007-2023