RESULTS OF APPENDICULAR PERITONITIS TREATMENT IN CHILDREN WITH ABDOMINAL CAVITY DRAINAGE AND PH ENVIRONMENT CORRECTION

The authors note an increase in the frequency of complications after open appendectomy, although open methods of treating complicated forms of appendicitis in children remain relevant, since the outcome in patients with appendicitis complicated by peritonitis largely depends on adequate surgical tactics and reliable elimination of the source of peritonitis. The aim of the study was to investigate comparative treatment results in children with appendicular peritonitis using abdominal cavity drainage and correction of the pH environment. A total of 189 patients operated on for appendicitis complicated by peritonitis were observed in 2018–2020. The study showed that biochemical blood parameters after surgery did not provide a clear picture of the severity and dynamics of the pathological process, whereas C-reactive protein was the most sensitive marker of inflammatory activity. The pH of the abdominal cavity was examined during and after open appendectomy and complex treatment of peritonitis, which included abdominal drainage through a right iliac access with glove drainage and injection of 1 ml of 0.5% salicylic acid on the second postoperative day. Analysis of the results demonstrated that the use of salicylic acid promoted a shift of the pH environment towards normalisation from the fifth day, which correlated with general clinical signs of improvement in the patients’ condition. The authors conclude that complex treatment of appendicular peritonitis with salicylic acid improves final outcomes in the early and late postoperative period in children by 4.3%.