Enteral Insufficiency Treatment in Patients With Generalized Peritonitis

Abstract

Objectives - to improve the treatment results in patients with generalized peritonitis complicated by the enteral insufficiency syndrome. Material and methods. In the period of 2016 -2018 there were 45 patients with a widespread peritonitis admitted to Samara regional clinical hospital named after V.D. Seredavin for treatment. The patients were divided into a control and a main group. The patients of the main group received the intestinal intubation with a specially designed catheter, the intestinal lavage during surgery and in the early postoperative period, the enterosorption, enteral nutrition and bowel decontamination; and in the absence of contraindications - the enteral oxygen therapy. Dynamics of the enteral insufficiency syndrome (EIS) development in both groups were evaluated according to the defined criteria, including laboratory and clinical indicators. Each criterion could weight from 1 to 3 points, their amount reflected the degree of enteral insufficiency. Results. In the main group of patients the small intestinal function was notably restored till the beginning of the third day, what coincided with the transition of the third degree of enteral insufficiency in the second. In patients of the control group the restoration of intestinal function was starting in period of fifth and sixth day after the operation, but the 3d degree of enteral insufficiency remained for 12 hours. Conclusion. The intestinal treatment in combination with the standard therapy allowed to reduce the degree of EIS in the beginning of treatment. This helped to improve the treatment results in general.

Method for prediction of enteral insufficiency in acute peritonitis

“…есмотря на совершенствование методов диагностики и лечения острых хирургических заболеваний живота, на современном этапе перитонит до сих пор остается одним из грозных осложнений и достигает 30-60% [1]. Одной из основных причин, оказывающих непосредственное влияние на течение и исход распространенного перитонита и способствующих в раннем послеоперационном периоде поддержанию воспалительного процесса в брюшной полости, является синдром энтеральной недостаточности (СЭН) [1][2][3][4][5][6].…”