Influence of intraabdominal hypertension on morphological changes of internal organs in experiment

Abstract

The development of intra-abdominal hypertension is possible with a wide range of surgical pathologies, in particular, the abdominal cavity, as well as in other nosologies and significantly aggravates the prognosis. Thus, polytrauma and major burns present up to 60% of the risk of abdominal compartment syndrome (AKS), and intestinal obstruction, peritonitis and acute destructive pancreatitis - in almost 80% of cases. The purpose of the work was to investigate the morphological changes that occur in the internal organs in an intraabdominal hypertension syndrome caused by peritonitis. The experiment was conducted on 28 guinea pigs, divided into three groups: I — the control group (n=8), the II group, in which the peritonitis was simulated by destruction of the colon in the experimental animals (n=10), III — the group of experimental animals, in which the peritonitis model was combined with a paranephrine blockade in combination with a blockage of the circular ligament of the liver (n=10). In all experimental animals, intraabdominal pressure was measured every 6 hours during the day. The results were processed using Microsoft Excel spreadsheet formulas using the Student t criterion. For morphological study section material was used (fragments of the kidneys, small intestine and peritoneum). To facilitate cutting the pieces, we carried out preliminary fixation of organs in 10% neutral formalin (at least 24 hours). From each organ, cut into 1–2 bits or ribbons, which were fixed in 10% neutral formalin solution. After posting according to the generally accepted method, bits were poured into paraffin. Paraffin sections 5–7 microns thick were stained with hematoxylin and eosin. As a result of experimental work, it has been found that combined regional blockades effectively reduce intra-abdominal pressure within six hours after use, but their effect is short-lived. In the experimental peritonitis group, with the implementation of regional blockades with lidocaine solution, the morphological changes of the kidneys and peritoneum were less pronounced. Improvement of the technique of regional blockades, in particular the continued infusion of local anesthetics, can significantly increase the effectiveness of the technique without side effects that are inherent in, in particular, peridural analgesia.