Features of Diagnostics and Treatment of Acute Appendicitis in Patients 
 of Infectious Hospital

Abstract

Introduction. Acute appendicitis occupies one of the leading positions in terms of incidence among urgent surgical diseases of the abdominal organs in Russia and in the world. Despite the accumulated experience in the diagnosis and treatment of the disease, a number of challenges still remain, leading to delayed diagnosis and, as a consequence, the development of destructive and complicated forms and deterioration of treatment outcomes. One of these "stumbling blocks" is the differential diagnosis of acute appendicitis and infectious diseases. In addition, acute appendicitis frequently develops together with existing acute and chronic infectious diseases, and appears to be also their complication. In our opinion, the absence of a specific algorithm of actions when dealing with this category of patients may be one of the reasons for unsatisfactory results. In this regard, there is a need to develop such an algorithm.Aim. Improvement of the therapeutic and diagnostic algorithm in relation to patients with OA admitted to infectious diseases hospitals, as well as evaluation of the results of its application.Materials and methods. The article presents diagnostics and treatment results of patients with acute appendicitis hospitalized in an infectious disease hospital, and compares their outcomes before and after implementation of the developed diagnostic and treatment algorithm. The study included 102 patients. The retrospective group included 55 patients with acute appendicitis, which developed together with acute or chronic infectious diseases, treated before implementation of the algorithm. The prospective group consisted of 47 patients treated using the developed algorithm.Results. . Gangrenous forms developed in 25 (45,5%) patients of the retrospective group, and in 8 (17%) patients of the prospective group. Peritonitis complicated the course of acute appendicitis in 53 (96,4%) patients of the retrospective group, while in patients of the prospective group this complication was noted in 25 (53,5%) cases. Purulent forms of peritonitis were noted in 20 (36,4%) patients of the retrospective group, and only in 3 (6,4%) patients of the prospective group. There was also a significant difference in the incidence of appendicular infiltration / abscess. This complication was registered in 11 (20%) patients of the retrospective group, in the prospective group it was noted in 2 (4,3%) patients. Postoperative complications were recorded in 8 (14.5 %) patients of the retrospective group. There were no postoperative complications in patients of the prospective group.Conclusion. The data obtained allow assuming that use of the proposed treatment and diagnostic algorithm in patients with acute appendicitis admitted to an infectious diseases hospital can positively affect timeliness of diagnosis and treatment and, as a consequence, improve treatment outcomes for this category of patients.