Systemic approach to imaging of acute abdominal surgical infection: a prospective study

Abstract

INTRODUCTION: The relevance of this work is due to the complexity of the treatment of severe acute surgical, especially destructive, infections of the abdominal cavity. The basis for improving results is the improvement of early radiological diagnosis of these diseases.OBJECTIVE: Of this study was to systematize the approaches in the radiodiagnosis of acute abdominal surgical infection.MATERIALS AND METHODS: The study analyzed the results of studies of 300 observations (men — 182, women — 128) aged 36 to 72 years who were treated at the Budgetary Institution «Surgut Regional Clinical Hospital» in the period from 2019 to 2022. The mean age of the patients was 49.2 years (59.7 years for men and 51 years for women). In the course of the study, a comparative analysis of the results of various methods of radiological examination in acute abdominal surgical infection was carried out, and key aspects of the radiodiagnosis algorithm were presented.Statistics. Statistical processing and systematization of these methods of radiation diagnostics was carried out with the calculation of sensitivity and specificity. The description of categorical variables was carried out using absolute values and a fraction of the whole — n (%). The results of calculating the indicators did not reveal significant differences in the group of men and women examined.RESULTS: At the initial stage of diagnosis, two main X-ray morphological syndromes of acute abdominal surgical infection were identified: a widespread inflammatory process (peritonitis and pancreatic necrosis) and a delimited inflammatory process (abscesses of various localizations). Based on the syndromic approach, not only the nosological diagnosis of this pathology wassubsequently carried out, but also approaches to the tactics of surgical treatment of patients were determined.DISCUSSION: The choice of the method of radiation examination of these patients, justified by the leading clinical and radiological syndrome, leads to early diagnosis and treatment of acute abdominal surgical infection.