ORIGINAL RESEARCH
Abdominal Surgery
doi: 10.25005/2074-0581-2026-28-2-422-433
INTRAABDOMINAL HYPERTENSION AND ENDOTOXICOSIS MARKERS AS CRITERIA FOR ASSESSING THE SEVERITY OF CHRONIC COLONIC STASIS

M.K. GULOV1, Z.M. NURZODA2, K.R. RUZIBOYZODA3, S.G. ALI-ZADE3

1Department of Topographic Anatomy and Operative Surgery named after Professor M.K. Karimov, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
2Department of General Surgery No. 1 named after Professor A.N. Kakharov, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan
3Department of Surgical Diseases No. 1 named after Academician K.M. Kurbonov, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

Objective: To assess the severity of intra-abdominal hypertension (IAH) and endotoxemia in patients at different stages of chronic colonic stasis (CCS), and to evaluate the relationship between intra-abdominal pressure (IAP) levels and markers of endotoxemia.

Methods: This single-center, observational, cross-sectional study included 92 adult patients with verified CCS (57 women, 35 men; mean age 48±12 years). Participants were categorized by CCS stage: compensated (n=31), subcompensated (n=33), and decompensated (n=28). IAP was measured using the indirect transvesical method according to the World Society of the Abdominal Compartment Syndrome (WSACS) guidelines. Laboratory markers included middle-mass molecules (MMM, λ=210 nm), C-reactive protein (CRP), leukocyte count, and serum creatinine. Quantitative data are presented as Median [Q1; Q3]. Intergroup differences were analyzed using the Kruskal-Wallis H-test with Dunn's post-hoc test and Holm's correction. Categorical variables were assessed via Pearson's χ² test and Cramer's V; correlations were determined using Spearman's coefficient (ρ).

Results: IAH was identified in 81% (n=75) of patients, with a 100% prevalence in the subcompensated and decompensated groups. The distribution of IAH grades differed significantly across CCS stages (χ²=97.043; p<0.001; V=0.726). Median IAP increased significantly from the compensated stage (9.2 [9.0; 10.2] mm Hg) to the subcompensated (16.0 [14.5; 18.0] mm Hg) and decompensated stages (22.7 [22.2; 23.4] mm Hg) (p<0.001). In the decompensated group, 61% of patients exhibited Grade III IAH. As CCS severity progressed, significant increases were observed in MMM (0.40, 0.60, and 0.70 arb. units), CRP (28.0, 65.0, and 105.0 mg/L), leukocyte count (7.8, 9.6, and 12.6×10⁹/L), and creatinine (75.0, 92.0, and 125.0 μmol/L) (p<0.001 for all). IAP correlated strongly with CCS stage (ρ=0.76; p<0.001) and moderately with CRP (ρ=0.56, p<0.001), creatinine (ρ=0.44, p<0.001), leukocytes (ρ=0.43, p<0.001), and MMM (ρ=0.28, p=0.007).

Conclusion: IAH develops in association with the progression of CCS and is accompanied by an intensified systemic inflammatory response and endotoxicosis. Laboratory findings indicate concomitant renal dysfunction. Monitoring IAP serves as a valuable clinical tool for assessing disease severity and stratifying the risk of complications in this patient population.

Keywords: Intra-abdominal pressure, intra-abdominal hypertension, chronic colonic stasis, endotoxicosis, C-reactive protein, creatinine.

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Authors' information:

Gulov Makhmadshokh Kurbonalievich,
Doctor of Medical Sciences, Full Professor, Professor of the Department of Topographic Anatomy and Operative Surgery named after Professor M.K. Karimov, Avicenna Tajik State Medical University
Researcher ID: D-7916-2018
ORCID ID: 0000-0001-5151-937X
SPIN: 5463-6781
Author ID: 305733 E-mail: gulovm@mail.ru

Nurzoda Zoirdzhon Mirakhmad,
Candidate of Medical Sciences, Associate Professor of the Department of General Surgery No. 1 named after Professor A.N. Kakharov, Avicenna Tajik State Medical University
ORCID ID: 0009-0004-8029-9803
SPIN: 8734-7933
Author ID: 1154420
E-mail: zoirjon.nurzoda.81@mail.ru

Ruziboyzoda Kakhramon Ruziboy,
Doctor of Medical Sciences, Associate Professor of the Department of Surgical Diseases No. 1 named after Academician K.M. Kurbonov, Avicenna Tajik State Medical University ORCID ID: 0000-0001-8381-0364
SPIN: 7343-3380
Author ID: 1005844
E-mail: dr.hero85@mail.ru

Ali-Zade Sukhrob Gaffarovich,
Candidate of Medical Sciences, Associate Professor of the Department of Surgical Diseases No. 1 named after Academician K.M. Kurbonov, Avicenna Tajik State Medical University
ORCID ID: 0000-0002-2456-7509
SPIN: 6854-5343
Author ID: 258253
E-mail: suhrob_a@mail.ru

Information about support in the form of grants, equipment, medications

The authors did not receive financial support from manufacturers of medicines and medical equipment

Conflicts of interest: No conflict

Address for correspondence:

Ruziboyzoda Kakhramon Ruziboy
Doctor of Medical Sciences, Associate Professor of the Department of Surgical Diseases No. 1 named after Academician K.M. Kurbonov, Avicenna Tajik State Medical University

734026, Republic of Tajikistan, Dushanbe, Sino str., 29-31

Tel.: +992 (934) 054404

E-mail: dr.hero85@mail.ru


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