Surgery

doi: 10.25005/2074-0581-2018-20-4-442-447
IMPROVEMENT OF PERITONITIS CLASSIFICATION

A.R. Saraev

Department of Surgical Diseases № 1, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Objective: Based on the existing classification schemes, to improve and implement the modern classification of peritonitis.

Methods: This research based on the experience of complex diagnostics and surgical treatment of 188 patients with advanced peritonitis treated at the Dushanbe City Emergency Medical Center. Today the classifications of peritonitis available and also have been analyzed and studied.

Results: Clinical manifestations of peritonitis widespread largely depended on the causes of the disease, its stage of progression. Analysis of real clinical practice shows that the terms «sepsis» and «severe sepsis» used interchangeably. Based on the study and literature review, a clinical classification of peritonitis has been developed, in which the stages of its development correspond to both the severity of clinical manifestations and the pathogenesis of peritonitis, which greatly optimizes further tactics and, thereby improves the results of treatment. Clinical comparison of the presented classification with the classification of K.S. Simonyan showed that in fact more often have a toxic phase of peritonitis (partially stages I and II according to our classification) since the reactive stage is more implies that is found in the practice of the surgeon. With regard to the terminal stage, as a final, its isolation is often impractical because in its essence it reflects the final process, i.e. its extreme neglect, which, of course, is not the rule and does not reflect the true statistics of peritonitis.

Conclusions: The developed and presented the classification of peritonitis has both practical and academic significance, and the gradation of the clinical stages of peritonitis is simple, allows you to give an objective assessment of the severity of the patient’s condition, to choose the optimal scheme of surgical treatment and intensive therapy of this difficult category of patients.

Keywords: Intoxication, abdominal sepsis, peritonitis classification.

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Authors informations:

Saraev Alisher Rakhmatulloevich, Candidate of Medical Sciences, Associate Professor of the Department of Surgical Diseases № 1, Avicenna Tajik State Medical University

Address for correspondence:

Saraev Alisher Rakhmatulloevich

Candidate of Medical Sciences, Associate Professor of the Department of Surgical Diseases № 1, Avicenna Tajik State Medical University

734003, Republic of Tajikistan, Dushanbe, Rudaki Aveю, 139

Tel.: +992 (918) 650540

E-mail: dr.saraev@mail.ru

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