Risk factors of abdominal complications of acute and chronic tonsillitis in children

Abstract

The authors revised domestic and foreign scientific articles devoted to the problem of the development of abdominal complications of tonsillitis and the methods of their prevention. Tonsillitis is one of the most common pathologies of ENT organs, inter alia, among children and adolescents. It is known that alongside with local complications, the palatine tonsils inflammation negatively affects the immune system as a whole, causing the development of various diseases of infectious and allergic nature, affects body sensitization and the development of chronic intoxication, promoted by a variety of tonsil microflora and tissue protein decomposition products. The morphological similarity of the palatine tonsils and the lymphoid tissue of the appendix in some cases suggests the idea of appendicitis as one of the complications of tonsillitis. The authors consider the disorder of the physiological function of the appendix as a primary change resulting from the local manifestations of hypersensitivity reactions. As a result of impaired immune homeostasis, there occurs a condition due to which the action of any viral or bacterial antigen on the intestinal wall activates the immune response, resulting in cell migration from the vascular bed to the appendix mucosa and, therefore, the formation of an immune inflammation focus. In most cases, the initial changes are reversible. It occurs when there is no stagnation in the organ lumen, a small dose of the incoming antigen, a low antibody titer, a weak tension of allergic reaction. In this case, destructive changes do not develop and the process regresses. However, under high sensitization of the body, in the lymphoid tissue, under the effect of even insignificant stimuli, there develops hyperergic inflammation, accompanied by hyperemia of all layers of the appendix wall and the necrosis of its lymphoid follicles. The interest in the interrelation of these diseases persists for many years. However, despite the improvement of clinical, laboratory and immunomorphological examination methods, the problem of predicting and preventing the abdominal complications of acute and chronic tonsillitis remains relevant.