Features of enteric insufficiency syndrome in patients with widespread peritonitis

Aim. To access the features of enteric insufficiency syndrome in patients with widespread peritonitis.

Methods. The survey of 98 patients with purulent peritonitis was performed. Enteric insufficiency syndrome severity was graded considering the stage of peritonitis treatment. The level of procalcitonin as a marker of sepsis was measured. Changes of abdominal index were analyzed.

Results. I grade of enteric insufficiency syndrome was found in 21 (21.4%) patients, II grade - in 47 (48%), III grade - in 30 (30.6%) of cases. Only enteric insufficiency syndrome grades I and II were registered in patients with reactive stage of peritonitis. At toxic stage of widespread peritonitis, II grade of enteric insufficiency syndrome prevailed and was registered in 60.8% of all cases (31 patients); III grade was diagnosed in 27.4% of cases (14 patients). At terminal stage of peritonitis, III grade of enteric insufficiency syndrome was diagnosed in 80% of patients, II degree - in 20%. In patients of the study sample, regardless of the stage of peritonitis and enteric insufficiency syndrome degree, average levels of procalcitonin were above normal, indicating the bacterial nature of intoxication. Abdominal index did not exceed 7 in patients with I grade of enteric insufficiency syndrome, 8-13 - in grade II, over 13 - in grade III.

Conclusion. A direct correlation between the enteric insufficiency syndrome and the severity of peritonitis was revealed; procalcitonin level is closely related to the severity of peritonitis and enteric insufficiency; there is a correlation between increased values of abdominal index and worsening of bowel function (r=1.841, p <0.05).