CLINICAL AND MORPHOLOGIC ANALYSIS OF PERITONITIS DEPENDING ON THE PREVALENCE AND DURATION OF THE PROCESS

To analyze the methods and tactics of treatment, indications for surgery, its type and volume in peritonitis, as well as to give morphological characteristics of the peritoneum in patients with peritonitis.

Materials and methods: the study was conducted in 1878 patients treated in the surgical department of the 4th City Clinical Hospital of Tashkent named after I. Irgashev during one calendar year, 2021.

Clinical, instrumental, biopsy and morphologic diagnostic methods were used in the study during operative and conservative treatment of peritonitis. The obtained results were processed and compared by statistical method.

Obtained results: the causes of peritonitis in the study group (124) were the following nosologic units : Acute appendicitis - 44%, perforated gastric and duodenal ulcer - 26%, pancreonecrosis - 6%, lesions of abdominal cavity and retroperitoneal organs - 9.6%, acute destructive cholecystitis - 6.4%, pinched hernia (postoperative, inguinal, femoral) - 3.2%, acute intestinal obstruction (adhesions, intestinal blockage) - 1.6%.
Despite the large number of scientific studies devoted to this problem, it is very relevant to conduct research on the choice of tactics and methods of treatment in patients with acute peritonitis, indications for surgical intervention, its type and volume.
The medical records of these 1878 patients (case histories and surgical logs) were also studied retrospectively.

Of these, 477 (25.4%) had acute appendicitis, 410 (21.8%) acute cholecystitis, 116 (6.2%) pancreatitis, 108 (5.8%) acute intestinal obstruction, 287 (15.3%) pinched hernia, 32 (1.7%) perforation of hollow organs, the remaining 448 (23.8%) peritonitis developed against the background of other surgical diseases: pancreatic tumor-1.6%, due to mesenteric vein thrombosis - in 1.6% of cases.

Interpretation of clinical and morphologic results allows to make a correct choice of method and tactics of treatment and reasonable pathogenetic approach.
Conclusions: taking into account the clinical course of peritonitis, duration and prevalence of the inflammatory process, as well as the appropriate response of morphologic structures of the peritoneum, the choice of the method and volume of surgical intervention leads to an increase in the effectiveness of treatment.