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Khirurgii

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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
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