EARLY ASSESSMENT AND DETERMINATION OF TREATMENT EFFECTIVENESS OF RELAPAROTOMY IN COMPLICATIONS OF DISSEMINATED PURULENT PERITONITIS
Abstract
Resume. Peritonitis is one of the most common complications of surgical diseases of the abdominal cavity, occurring in up to 90% of abdominal organ pathologies in surgical patients. The mortality rate in local and diffuse purulent peritonitis is 5–55%, while in disseminated peritonitis it reaches 75–80%. Due to the poor outcomes in the treatment of secondary peritonitis, purulent-inflammatory complications remain common. Peritonitis continues to be one of the major challenges in 21st-century surgery. Inflammation of the peritoneum is accompanied by both local and systemic symptom complexes. Researchers refer to it as microbial peritonitis because the main source is destructive inflammation in the abdominal organs. The peritoneum performs protective, excretory, and plastic functions. With a total surface area of 1600–2050 cm², the peritoneum can absorb up to 70–80 liters of fluid per day, which represents its leading protective function. The high mortality rate in peritonitis highlights the severity of the condition. The poor prognosis and high fatality rates indicate that several issues remain unresolved for surgeons, particularly in cases of secondary peritonitis. Rapidly developing intoxication and prolonged intestinal paresis play key roles in the pathogenesis of peritonitis. During the toxic stage, detoxification methods such as hemosorption, hyperbaric oxygenation, lymphosorption, and plasmapheresis help reduce mortality in patients with diffuse and disseminated purulent peritonitis. Keywords: disseminated peritonitis, relaparotomy, intestinal paresis, endotoxicosis, detoxification, decompression.