MODERN CAUSATIVE PATHOGENS OF PERITONITIS IN CASES OF THE PERFORATION OF THE STOMACH, SMALL INTESTINE OR COLON IN CHILDREN AND OPTIMIZATION OF THE DIFFERENTIATED TREATMENT OF PATIENTS

Abstract

67 purulent peritonitis children (excluding newborns) aged of from 1.5 months to 15 years treated in the hospital from 2007 to 2016 for gastric or intestinal perforation at different levels were examined. These children were divided in 2 groups of patients with purulent peritonitis, matched for the gender, age and severity of the disease. The control group of the examined patients comprised 36 children, who were treated in the period of 2007-2012 for a purulent peritonitis of non-appendiceal genesis. The main group of cases included 31purulent peritonitis patients with perforation of the stomach or intestines, who was treated during the period of 2012--2016. In all 67 patients in both groups, the causes of perforation of the hollow organs - the stomach, small intestine or large intestine - with the development of purulent peritonitis were detected and remained the same for years. The severity of the course of purulent peritonitis of non-appendiceal genesis and the difficulty of treating such patients mostly depended on the patient’s age, disease nosology and background diseases. The basis for successful implementation of the treatment is the difference in the etiology of the disease and the degree of danger of the pathogen of the purulent process, depending on the level of perforation of the intestinal tube. Virulence of the pathogen and antibiotic susceptibility of purulent mono- or mixt-infection significantly influenced the severity of purulent peritonitis and the outcome of the treatment. The authors developed and proposed a complex of the differentiated etiopathogenetic treatment of patients with purulent peritonitis of non-appendiceal genesis with a decrease in the mortality rate. The basis for the successful implementation of the treatment is the difference in the etiology of the disease and the degree of danger of the pathogen of the purulent process, depending on the level of perforation of the intestinal tube.