ORIGINAL RESEARCH
General Surgery
doi: 10.25005/2074-0581-2024-26-3-399-406
PREDICTION OF PERSISTENT PERITONITIS IN THE POSTOPERATIVE PERIOD

J.A. ABDULLOZODA1, A.R. SARAEV2, SH.K. NAZAROV2, S.G. ALI-ZADE2

1Department of General Surgery № 2, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
2Department of Surgical Diseases № 1 named after Academician K.M. Kurbonov, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Objective: Improve the treatment results of patients with diffuse peritonitis by accurately predicting the progression of persistent peritonitis to septic shock in the postoperative period

Methods: The study involved 75 patients with diffuse peritonitis. These patients were split into two groups based on whether their peritonitis persisted after surgery and if they needed further surgery. The study used pre- and intraoperative clinical and laboratory predictors to determine the progression of peritonitis to septic shock

Results: The preoperative CT attenuation coefficient of intraperitoneal fluid, measured in Hounsfield units (HU), was significantly higher in the study group compared to the control group (28.35 HU vs. 18.3 HU; p<0.001). The scores on the Mannheim Peritonitis Index (MPI) were also significantly higher in the study group compared to the control group (25 versus 16; p<0.001). Additionally, the levels of presepsin (PSEP), procalcitonin (PCT), and C-reactive protein (CRP) were higher in the study group compared to the control group (p<0.001): 1149.1 (153.7-2591) pg/ml, 12.7815 (4.286-22.557) ng/ml, and 232.5 (162.2-312.4) mg/l in the study group, and 410.3 (56.1-980.9) pg/ml, 3.087 (0.995-13.399) ng/ml, and 120.8 (25.7-280) mg/l in the control group, respectively

Conclusion: The proposed method for predicting the progression of peritonitis to septic shock is based on the MPI score and the CT attenuation coefficient of intraperitoneal fluid, in combination with biomarkers of inflammation such as PSEP, PCT, and CRP. This method allows practical surgeons to recognize persistent peritonitis, be prepared for the deterioration of a patient's condition with the progression of persistent peritonitis to septic shock, and perform a timely and appropriate surgical intervention

Keywords: Persistent peritonitis, tertiary peritonitis, Hounsfield unit, inflammatory markers.

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References
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Authors' information:

Abdullozoda Jamoliddin Abdullo,
Doctor of Medical Sciences, Professor of the Department of General Surgery № 2, Avicenna Tajik State Medical University
ORCID ID: 0000-0002-8509-4231
SPIN: 9268-0866
Author ID: 960954
E-mail: Abdullozoda-Jamoliddin@mail.ru

Saraev Alisher Rakhmatulloevich,
Doctor of Medical Sciences, Associate Professor of the Department of Surgical Diseases № 1 named after Academician R.M. Kurbonov, Avicenna Tajik State Medical University Researcher ID: F-5504-2019
ORCID ID: 0000-0001-9695-1924
SPIN: 6911-9887
Author ID: 849178
E-mail: dr.saraev@mail.ru

Nazarov Shokhin Kuvvatovich, Doctor of Medical Sciences, Head of the Department of Surgical Diseases № 1 named after Academician K.M. Kurbonov, Avicenna Tajik State Medical University Researcher ID: F-5504-2019 ORCID ID: 0000-0003-2099-2353 SPIN: 1817-7089 Author ID: 845034 E-mail: shohin67@mail.ru

Ali-Zade Sukhrob Gaffarovich,
Candidate of Medical Sciences, Associate Professor of the Department of Surgical Diseases № 1 named after Academician K.M. Kurbonov, Avicenna Tajik State Medical University
ORCID ID: 0000-0002-2456-7509
SPIN: 6854-5343
Author ID: 258253
E-mail: suhrob_a@mail.ru

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Saraev Alisher Rakhmatulloevich
Doctor of Medical Sciences, Associate Professor of the Department of Surgical Diseases № 1 named after Academician R.M. Kurbonov, Avicenna Tajik State Medical University

734026, Republic of Tajikistan, Dushanbe, Sino str., 29-31

Tel.: +992 (918) 650540

E-mail: dr.saraev@mail.ru

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