A criterion of choice for surgical intervention in children with appendicular peritontis

Abstract

Purpose: to select the surgical approach in appendicular peritonitis using the peritonitis index and laparoscopic intraoperative assessment of abdominal inflammation intensity.Methods and materials: experience of treating 186 patients with appendicular peritonitis is presented. Retrospective analysis of medical records of 186 patients with complicated appendicitis in 2011–2014 was performed. It was accompanied by prospective analysis substantiating the criteria for laparoscopic intraoperative assessment of the intensity of abdominal inflammatory changes in 2015 to 2018.Results. In our study, there were 98 cases (52.6%) of local peritonitis in the total structure of peritonitis (186 cases). 57 cases (30.6%) of diffuse peritonitis were observed. Among patients with acute appendicitis (1863 cases) during the examined period, local peritonitis was found in 5.2% of patients, diffuse peritonitis – in 3.05% of patients.Conclusion: criteria assessing the intraoperative severity of peritonitis enabled to decrease the rate of laparotomy from 9.1% to 6.45%.