Abstract
In conditions of abdominal sepsis with indications of first- or second-stage shock, blood cells undergo significant ultrastructural changes that cause impaired gas exchange, changes in reactivity, and decompensation of organs and systems functions. This paper presents a cross-sectional prospective study aimed at researching the ultrastructure of blood cells in children experiencing abdominal septic shock against the background of generalized purulent peritonitis of appendicular origin. This study was conducted with 15 children aged 6–12 who were undergoing treatment for generalized appendicular purulent peritonitis, with first- or second-stage abdominal septic shock, in emergency care. The changes in the ultrastructure of erythrocytes did not correspond to changes characteristic of eryptosis, which confirms their occurrence under the influence of such pathogenic factors as intoxication, metabolic, water–electrolyte balance, and acid–base disorders. Ultrastructural changes of granulocytes indicate their hyperactivation, which leads to the exhaustion of membrane synthetic resources, membrane destruction, ineffective expenditure of bactericidal factors on substrates that are not subject to destruction. In lymphocytes, disorganization of the nuclear membrane and intracellular membranes, uneven distribution of chromatin, the hypertrophied Golgi apparatus, and a large number of young mitochondria, lysosomes, ribosomes, vesicles manifesting the disruption of metabolism, stress and decompensation of energy supply and protein synthesis systems, have been demonstrated. In conditions of abdominal sepsis with indications of first- or second-stage shock, blood cells undergo substantial ultrastructural changes causing gas exchange disruption, changes in reactivity, as well as decompensation of organs and system functioning.
Highlights
IntroductionChildren 2020, 7, 189 diagnosis [2]
Acute appendicitis (AA) is the most common surgical emergency the world over [1], yet it is difficult to diagnose, especially in women, for whom there is a broader range for differentialChildren 2020, 7, 189; doi:10.3390/children7100189 www.mdpi.com/journal/childrenChildren 2020, 7, 189 diagnosis [2]
The results of our study in children suffering from abdominal sepsis with first- and second- stage shock show the changes of ultrastructure of erythrocytes, granulocytes, and lymphocytes
Summary
Children 2020, 7, 189 diagnosis [2]. Every year this illness appears in 90–100 out of 100,000 patients living in developed countries. The risk for developing AA during one’s lifetime is 8.6% for men and 6.7% for women, with the illness most often occurring between the ages of 10 and 30 [3]. Conducted on a group of 38,939 children, the estimated risk of the appearance of AA in patients under age 18 was 2.5%. Geographical variations have been noted in the incidence of the illness over the course of a lifetime, with a frequency of 16% in South Korea, 9% in the USA, and 1.8% in Africa [5,6].
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