Peritonitis Research Articles

A Model of Acute Peritonitis.

The biological models used in the study of generalized peritonitis can be subdivided into 5 groups (introduction of foreign bodies, cultures of microorganisms, suspensions of feces, chemicals, and mechanical damage to the gastrointestinal tract) or into 4 groups (introduction of foreign bodies, chemicals, bacterial contamination of the abdominal cavity, and combined methods). After analysis of published reports, the most justified classification of methods of peritonitis modelling is based on the type of peritonitis-inducing agent and the administration route and on the nature of peritonitis developing in the abdominal cavity. The choice of the model maximally close reproducing clinical conditions of peritonitis should be based on the specific objectives of the study, focusing on the etiology, pathogenesis, and severity of the disease course, planned measures aimed at eliminating the process, and other factors.

Epidemiology and risk factors for mortality in critically ill patients with pancreatic infection

BackgroundThe AbSeS-classification defines specific phenotypes of patients with intra-abdominal infection based on the (1) setting of infection onset (community-acquired, early onset, or late-onset hospital-acquired), (2) presence or absence of either localized or diffuse peritonitis, and (3) severity of disease expression (infection, sepsis, or septic shock). This classification system demonstrated reliable risk stratification in intensive care unit (ICU) patients with intra-abdominal infection. This study aimed to describe the epidemiology of ICU patients with pancreatic infection and assess the relationship between the components of the AbSeS-classification and mortality. MethodsThis was a secondary analysis of an international observational study (“AbSeS”) investigating ICU patients with intra-abdominal infection. Only patients with pancreatic infection were included in this analysis (n=165). Mortality was defined as ICU mortality within 28 days of observation for patients discharged earlier from the ICU. Relationships with mortality were assessed using logistic regression analysis and reported as odds ratio (OR) and 95% confidence interval (CI). ResultsThe overall mortality was 35.2% (n=58). The independent risk factors for mortality included older age (OR=1.03, 95% CI: 1.0 to 1.1 P=0.023), localized peritonitis (OR=4.4, 95% CI: 1.4 to 13.9 P=0.011), and persistent signs of inflammation at day 7 (OR=9.5, 95% CI: 3.8 to 23.9, P<0.001) or after the implementation of additional source control interventions within the first week (OR=4.0, 95% CI: 1.3 to 12.2, P=0.013). Gram-negative bacteria were most frequently isolated (n=58, 49.2%) without clinically relevant differences in microbial etiology between survivors and non-survivors. ConclusionsIn pancreatic infection, a challenging source/damage control and ongoing pancreatic inflammation appear to be the strongest contributors to an unfavorable short-term outcome. In this limited series, essentials of the AbSeS-classification, such as the setting of infection onset, diffuse peritonitis, and severity of disease expression, were not associated with an increased mortality risk.ClinicalTrials.gov number: NCT03270345

543 Is It the End of Hartmann’s Procedure for Perforated Diverticulitis with Peritonitis? an Updated Systematic Review and Meta-Analysis

Abstract Aim Hartmann’s procedure is the standard technique in the management of perforated diverticulitis. However, many recent studies showed that primary resection and anastomosis have better outcomes. Our aim is to compare HP’s outcomes versus PRA for Hinchey III and IV acute diverticulitis. Method PUBMED, Scopus, and Web of science were searched from inception to September 2022 for all studies comparing the outcomes of HP versus RPA for perforated diverticulitis with peritonitis and a systematic review and meta-analysis were done. Results 29 studies with a total of 4314 participants were included in our study. The pooled results of the included studies showed a remarkable decrease in mortality after PRA (Mortality, RR = 1.38, 95% CI = 1.09-1.73, P = 0.007). However, PRA is associated with a slight increase in the incidence of leakage (Leakage, RR = 0.40, 95% CI = 0.16-1.01, P = 0.05). Nevertheless, no difference in the overall incidence of complications between the two surgeries including SSI, wound dehiscence, bleeding, ileus and reoperation. (Overall incidence of complications, RR = 1.01, 95% CI = 0.84-1.21, P = 0.95). However, PRA is associated with shorter hospital stays but longer operative time. Moreover, those who had PRA with ileostomy had a higher stoma closure rate in comparison to HP (Closure rate, RR = 0.63, 95% CI = 0.49-0.81, P = 0.0003). Conclusions With a lower incidence of mortality, equal rates of complication and higher stoma reversal rates, RPA offers an excellent alternative to HP for perforated diverticulitis with purulent or feculent peritonitis.

Damage control surgery by transverse colon perforation: case report

Obstruction and perforation due to colorectal cancer represent challenging matters in terms of diagnosis, life-saving strategies, obstruction resolution and oncologic challenge. The outcomes of these different resections when performed in acute clinical situations remain substantially unexplored. Case report: 65 years old diabetic and obese female, with abdominal pain accompanied by the absence of channeling of flatus and bowel movements as well as countless vomiting of low intestinal content, wich is why its refer to the emergency of the IAHULA, Merida Venezuela. Physical examination: tachycardic, tachypneic, with, HR: 130 TA: 90/60, FR: 28m oxygen saturation 89%. Abdomen distended, diminished hydro aerial sounds, painful on palpation, with voluntary muscular defense. An emergency laparotomy show: general fecal peritonitis, perforations of the transverse colon, stenosing sigmoid tumor. For this reason, phase 1 damage control surgery was performed by transversectomy + placement of proximal and distal threads, requiring phase II in an intensive care unit, ventilatory support and vasopressor drugs. Phase III was planned in 48 to 72 hours for probable complete left colectomy, however, the patient died after 18 hours of postoperative. Discussion: damage control surgery has been considered an appropriate approach to the treatment of critically ill patients with severe intra-abdominal sepsis. Conclusion: Abdominal sepsis and a septic shock are both possible as a critical scenarios in patients with perforation and obstruction of the colon secondary tumors and carcinomas, for that reason it is important to know which patient can be selected to a damage control surgery in orden to improve the morbimortality.

Acute peritonitis caused by the acute pancreatitis of an ectopic pancreas in a jejunal duplication, in an adult with intestinal malrotation: a case report

BackgroundIntestinal duplication and ectopic pancreas are two rare independent congenital anomalies. Few reports describe cases of patients with ectopic pancreas in an intestinal duplication causing acute peritonitis.Case presentationA 31-year-old man was admitted to the hospital for epigastric pain. The patient was diagnosed with acute peritonitis caused by the acute pancreatitis of an ectopic pancreas in a jejunal duplication, with intestinal malrotation. The patient underwent the partial resection of the jejunum and Ladd’s procedure. The histopathological findings indicated ectopic pancreatitis in the jejunal duplication.ConclusionsWe presented the case of acute peritonitis caused by the acute pancreatitis of an ectopic pancreas in a jejunal duplication in an adult with intestinal malrotation. Surgery is the primary treatment and is necessary for a definitive diagnosis.

Gut microbiota and changes in cytokine profile in animals with experimental acute disseminated peritonitis on the background of diabetes

In the pathogenesis of acute widespread peritonitis and accompanying diabetes, a vital link is an endogenous intoxication caused by the translocation of microorganisms and their toxins from the intestine into the blood, metabolic changes, and immunological reactivity of the body. Our work aimed to investigate the microbial composition in the parietal intestinal biotope and the features of the blood cytokine profile in animals with acute disseminated peritonitis on the background of streptozotocin-induced diabetes. The study was conducted on 56 sexually mature non-linear white male rats. Diabetes mellitus was modeled by a single intraperitoneal injection of streptozotocin (60 mg/kg). On the 14th day of the development of streptozotocin-induced diabetes mellitus, a 10% filtered fecal suspension (0.5 mL) was injected into the abdominal cavity of animals, and acute generalized peritonitis was initiated. Sowing on nutrient media was carried out for bacteriological research to isolate a pure culture of microorganisms and their identification. The concentration of TNF-α, IL-1β, and IL-6 was studied by solid-phase enzyme immunoassay. The research results demonstrate an imbalance of cytokines in the dynamics of experimental acute disseminated peritonitis against the background of diabetes and quantitative and qualitative changes in the microbiota of the parietal intestinal biotope. A decrease in the number of Escherichia coli strains isolated in monoculture and an increase in the number of two-component and three-component microbial associations were revealed, among which Enterobacter aerogenes, Escherichia coli, Bacteroides spp., Proteus mirabilis, Klebsiella spp. and Candida species prevailed.

FTP2.7 Omental-derived Stromal-vascular Cell Fraction / Alginate Gel Composite Vs Control to Improve Murine Colonic Anastomotic Leak Rate – M-OMENTUM Randomised Controlled Study

Abstract Aim Colorectal anastomotic leak (AL) remains a significant challenge. The M-OMENTUM study compared omental-derived stromal-vascular cell-fraction (OSVCF) / alginate gel composite vs control subgroups to prevent murine AL. Methods C57BL-6 mice were subjected to an AL model with a leak rate (LR) of 40% and randomised (1:1) to OSVCF / alginate gel or control subgroups (gel alone and no treatment) powered to detect a 20% minimum difference (50% absolute reduction in LR); HO Licence PP9886008. Mice underwent laparotomy and colo-colonic anastomoses. In the intervention group, OSVCF was harvested and applied to the anastomosis in an alginate gel. Mice underwent schedule 1 killing at day 7 or earlier if they failed to meet wellness thresholds. The primary outcome was LR. Secondary outcomes included leak severity, weight, and adhesion score. An intention-to-treat analysis was performed. Results 128 mice (M:64/F:64), mean age 13.1 weeks (SD,1.2), mean weight, 24.1g (SD,4.3) were randomised. OSVCF/Gel containing mean 3.3x103cells/mg (SD,0.3x103) was applied in the intervention group. Overall LR was 49.2%. There was a numerical difference in LRs between the intervention group (30/64, 46.9%) and control groups (33/64, 51.5%) with a LR reduction of 9.1% (RR 0.91 [95%CI:0.64-1.69]; P=0.72). 12/33(36.4%) that received gel alone and 5/33(15.2%) that received no treatment developed an abscess rather than feculent peritonitis (RR 2.26 [95%CI:1.11-5.20]; P=0.04). Conclusions OSVCF/gel produced a 9.1% reduction in LR, but this did not reach statistical significance. The application of gel to an anastomosis alters the severity of anastomotic leak, favouring abscess formation rather than faecal peritonitis.

Sesquiterpene from Artemisia argyi seed extracts: A new anti-acute peritonitis agent that suppresses the MAPK pathway and promotes autophagy.

To find novel anti-inflammatory drugs, we screened anti-inflammatory compounds from 18 different types of Artemisia argyi seed extracts. The in vitro and in vivo anti-inflammatory activities of the screened compounds and their mechanisms were characterized. We first detected the cytotoxic effect of the compounds on RAW264.7 cells and the inhibitory effect on LPS-induced NO release. It was found that sesquiterpenoids CA-2 and CA-4 had low cytotoxic and strong NO inhibitory activity with an IC50 of 4.22 ± 0.61μM and 2.98 ± 0.23μM for NO inhibition, respectively. Therefore, compound CA-4 was studied in depth. We found that compound CA-4 inhibited LPS-induced pro-inflammatory factor production and M1 macrophage differentiation in RAW264.7 cells. Additionally, CA-4 inhibited the expression of p-ERK1/2, p-JNK, iNOS, and COX-2 by blocking the MAPK signaling pathway. CA-4 also promoted the expression of autophagy-related proteins such as LC3 II and Beclin-1 by inhibiting activation of the PI3K/AKT/mTOR signaling pathway, and promoted the generation of autophagosomes. Finally, CA-4 significantly inhibited the degree of inflammation in mice with acute peritonitis, showing good anti-inflammatory activity in vivo. Consequently, compound CA-4 may be a promising drug for the treatment of acute inflammatory diseases and provide new ideas for the synthesis of novel anti-inflammatory compounds.

Double Gastric and Duodenal Perforations at The Fousseyni Daou Hospital in Kayes in One Case

We report the observation of a patient presenting with acute generalized peritonitis. Emergency surgery found a double perforation, one on the stomach and the other on the duodenum. We performed a suture revival of the perforations plus a gastro-entero-anastomosis, then washed and drained the cavity. We discuss the diagnostic and therapeutic features of this rare condition.

Right adrenal mematoma causing partial small bowel obstruction in a term neonate

Adrenal haematoma in the neonate commonly occurs during the first week of life and usually proceeded by either mechanical trauma or metabolic stresses including hypoxia, hypovolaemia, septicaemia and coagulopathy. Haematomas commonly present with abdominal mass, anemia and hypovolaemia. The authors report a large for gestational age male newborn who presented with partial small bowel obstruction following adrenal haematoma in a background of an otherwise uneventful vaginal delivery. Although this presentation is extremely rare, it is important to timely investigate all sick newborns with presentations which mimic acute surgical abdomen. Accurate diagnosis enables both avoidance of unnecessary surgical explorations and optimal conservative management.

Diagnostic Clues for Women with Acute Surgical Abdomen Associated with Ruptured Endometrioma.

(1) Background: An investigation of the preoperative diagnostic clues used to identify ruptured endometrioma by comparing the ruptured and unruptured states in patients who underwent laparoscopic operations due to endometrioma. (2) Methods: Patients with ruptured endometriomas (14 patients) and unruptured endometriomas (60 patients) were included, and clinical symptoms, laboratory findings, and radiological findings were analyzed. (3) Results: There were no significant differences in age, parity, last menstrual cycle days, or median size of endometrioma between two groups (group A: ruptured; group B: unruptured). The median serum level of CA 125 was 345.1 U/mL in group A and 49.8 U/mL in group B (p = 0.000). The median serum levels of CA 19-9 in group A and B were 46.0 U/mL and 19.1 U/mL, respectively (p = 0.005). The median serum level of CRP in group A was 1.2 g/dL, whereas it was 0.3 in group B (p = 0.000). ROC analysis showed that the optimal CA 125 cutoff value was 100.9 U/mL; the optimal CA 19-9 cutoff value was 27.7 U/mL; and the optimal CRP cutoff value was 1.0 g/dL. (4) Conclusions: Ruptured endometrioma can be diagnosed preoperatively using a combination of clinical symptoms, laboratory findings, and radiological findings. If a physician suspects a ruptured endometrioma, surgery should be performed to ensure optimal prognosis.

TREATMENT WITH HUMAN UMBILICAL CORD-DERIVED MESENCHYMAL STEM CELLS IN A PIG MODEL OF SEPSIS-INDUCED ACUTE KIDNEY INJURY: EFFECTS ON MICROVASCULAR ENDOTHELIAL CELLS AND TUBULAR CELLS IN THE KIDNEY.

Background: Approximately 50% of patients with sepsis develop acute kidney injury (AKI), which is predictive of poor outcomes, with mortality rates of up to 70%. The endothelium is a major target for treatments aimed at preventing the complications of sepsis. We hypothesized that human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) could attenuate tubular and endothelial injury in a porcine model of sepsis-induced AKI. Methods: Anesthetized pigs were induced to fecal peritonitis, resulting in septic shock, and were randomized to treatment with fluids, vasopressors, and antibiotics (sepsis group; n = 11) or to that same treatment plus infusion of 1 × 10 6 cells/kg of hUC-MSCs (sepsis+MSC group; n = 11). Results: At 24 h after sepsis induction, changes in serum creatinine and mean arterial pressure were comparable between the two groups, as was mortality. However, the sepsis+MSC group showed some significant differences in comparison with the sepsis group: lower fractional excretions of sodium and potassium; greater epithelial sodium channel protein expression; and lower protein expression of the Na-K-2Cl cotransporter and aquaporin 2 in the renal medulla. Expression of P-selectin, thrombomodulin, and vascular endothelial growth factor was significantly lower in the sepsis+MSC group than in the sepsis group, whereas that of Toll-like receptor 4 (TLR4) and nuclear factor-kappa B (NF-κB) was lower in the former. Conclusion: Treatment with hUC-MSCs seems to protect endothelial and tubular cells in sepsis-induced AKI, possibly via the TLR4/NF-κB signaling pathway. Therefore, it might be an effective treatment for sepsis-induced AKI.

Management of complications related to colorectal endoscopic submucosal dissection.

Compared to endoscopic mucosal resection (EMR), colonoscopic endoscopic submucosal dissection (C-ESD) has the advantages of higher en bloc resection rates and lower recurrence rates of colorectal neoplasms. Therefore, C-ESD is considered an effective treatment method for laterally spread tumors and early colorectal cancer. However, C-ESD is technically more difficult and requires a longer procedure time than EMR. In addition to therapeutic efficacy and procedural difficulty, safety concerns should always be considered when performing C-ESD in clinical practice. Bleeding and perforation are the main adverse events associated with C-ESD and can occur during C-ESD or after the completion of the procedure. Most bleeding associated with C-ESD can be managed endoscopically, even if it occurs during or after the procedure. More recently, most perforations identified during C-ESD can also be managed endoscopically, unless the mural defect is too large to be sutured with endoscopic devices or the patient is hemodynamically unstable. Delayed perforations are quite rare, but they require surgical treatment more frequently than endoscopically identified intraprocedural perforations or radiologically identified immediate postprocedural perforations. Post-ESD coagulation syndrome is a relatively underestimated adverse event, which can mimic localized peritonitis from perforation. Here, we classify and characterize the complications associated with C-ESD and recommend management options for them.

Intensive Management of Diffuse Peritonitis Caused by Spontaneously Healed Gastric Perforation: A Case Report

Background: Gastric perforation will cause acute peritonitis. Proper diagnosis and management, especially in ICU, are needed to prevent complications and even death from this event. This study aimed to describe the intensive management of diffuse peritonitis caused by gastric perforation.&#x0D; Case presentation: A 61 years old male patient presented with pain in the whole abdomen for 6 days before admission. The pain began at the epigastrium and suddenly spread to the whole abdomen. The pain was felt continuously and increased by movement. Routine blood examination revealed anemia, lekousitosis, and radiology examination found homogeneous confluence was found in the abdominal, dilated small intestine, psoas line was not visible, in the left lateral decubitus position, an air-fluid level and free air were found. The patient underwent diagnostic laparoscopic surgery + peritoneal lavage on emergency surgery for 2 hours, obtained a resolution of gastric perforation, and the patient was treated postoperatively in the ICU of Dr. M. Djamil General Hospital.&#x0D; Conclusion: Cases of spontaneous resolution of gastric perforation are not only in terms of surgical management but in terms of postoperative care. It also plays an important role in the success and good results in cases of gastric perforation.

Acute surgical abdomen during the COVID-19 pandemic: a retrospective study on clinical and therapeutic challenges

Background As with other medical specialties throughout the epidemic, general surgical clinics’ treatment protocols have changed because of the COVID-19 pandemic, which has become a serious danger to healthcare systems. The presence of severe COVID-19 in young individuals and among medical workers has exacerbated the psychological burden on clinicians treating patients suspected of having or being infected with SARS-CoV-2, even if comorbidities and older age are statistically linked to higher death rates. Patients and methods A retrospective comparative study included patients who were admitted to the emergency room (ER), surgical, or managing conservatory for acute surgical abdomen. All subjects were divided into three groups. 1186 patients; out of them, 490 cases were examined before the pandemic, 334 cases were examined during the pandemic, and 362 cases were examined after vaccination. Results Before the pandemic, the commonest cause of acute abdomen was appendicitis (21.8%), strangulated hernia (21%), and cholecystectomy (17.8%). During the pandemic, the commonest cause of acute abdomen was appendicitis (21.8%), cholecystectomy (16.8%), and Mesenteric venous occlusion (MVO)/Mesenteric Artial occlusion (MAO) (13.8%). After the pandemic, the commonest causes of acute abdomen were cholecystectomy (25.4%), appendicitis (24.6%), and exploration abdomen (11.9%). The time of management differed significantly among the studied groups. The highest requirement for immediate intervention was attributed to the before pandemic group, while during the pandemic group was associated with conservative management, and after conservative management. Conclusion The Sars-Cov-2 pandemic highly affected the clinical presentation, aetiology, diagnostic and paraclinical investigations, and therapeutic management, as well as the changes in emergency practice procedures.

Non-Traumatic Abdominal Surgical Emergencies in the Field of HIV: A Series of 22 Cases in the Visceral and Digestive Surgery Department of the Siguiri Prefectural Hospital

Introduction: This study aimed to describe the epidemiological-clinical and therapeutic aspects of abdominal surgical emergencies on the ground of HIV in the department of visceral and digestive surgery of the prefectural hospital of Siguiri. Method: This was a descriptive prospective study which concerned patients operated on for abdominal surgical emergencies in the field of HIV, carried out in the visceral and digestive surgery department of the Siguiri prefectural hospital. Results: Out of a total of 88 cases of abdominal surgical emergencies operated on during our study, we collected 22 cases on HIV ground, i.e. 25%. The female sex dominated, including 14 women against 8 men, i.e. a sex ratio of 0.6 with an average age of 35 years. Miners were the most affected socio-professional layer, i.e. 31.80%, followed by traders and housewives, i.e. 27.30% each. HIV type I affected 77.27% against 22.73%. There were 41% of our patients who knew their serological status among which 66.66% were on ARV treatment and 33.33% were not on ARV treatment. The symptomatology was dominated by abdominal pain in 100% followed by fever in 77.27%. Appendicitis accounted for 40.09% followed by generalized acute peritonitis in 31.82%. The management was medico-surgical with pre-operative, intra-operative and post-operative resuscitation. The average length of hospitalization was 7 days. The postoperative course was favorable in 45.45%, we recorded 36.36% parietal suppuration and the mortality rate was 13.64%. Conclusion: Abdominal surgical emergencies in the field of HIV remain a major health problem in terms of care. The clinical pictures are dominated by acute appendicitis and generalized acute peritonitis.

Is the Mannheim index still useful in the prognosis of patients with secondary acute peritonitis?

Is the Mannheim index still useful in the prognosis of patients with secondary acute peritonitis?

Pancreas-sparing partial duodenectomy as an alternative to emergency pancreaticoduodenectomy for a major duodenal perforation: a case report.

A 71-year-old woman underwent endoscopic submucosal dissection for early duodenal cancer at the second portion of the duodenum and developed acute peritonitis due to delayed duodenal perforation. Emergency laparotomy was performed. A huge perforation formed at the descending duodenum without ampulla involvement. Pancreas-sparing partial duodenectomy (PPD) with gastrojejunostomy was performed (250min operative time) with 50mL of intraoperative blood loss. She required intensive care for 3days and was discharged on postoperative day 21 with no severe complications. Emergency treatment for a major duodenal injury or perforation remains challenging because of high morbidity and mortality. An appropriate treatment should be considered according to the nature of the defect. Although PPD is an acceptable procedure for patients with a duodenal neoplasm, its use in emergency surgery is rarely reported. PPD is more reliable than primary repair or anastomosis using a jejunal wall, and less invasive than pancreaticoduodenectomy, for emergency treatment. We performed PPD in this patient because the duodenal perforation was too large to reconstruct and did not involve the ampulla. PPD can be a safe and feasible alternative surgical procedure to pancreaticoduodenectomy for a major duodenal perforation, especially in patients with a duodenal perforation that does not involve the ampulla.

Nickle-cobalt alloy nanocrystals inhibit activation of inflammasomes.

Activation of inflammasomes-immune system receptor sensor complexes that selectively activate inflammatory responses-has been associated with diverse human diseases, and many nanomedicine studies have reported that structurally and chemically diverse inorganic nanomaterials cause excessive inflammasome activation. Here, in stark contrast to reports of other inorganic nanomaterials, we find that nickel-cobalt alloy magnetic nanocrystals (NiCo NCs) actually inhibit activation of NLRP3, NLRC4 and AIM2 inflammasomes. We show that NiCo NCs disrupt the canonical inflammasome ASC speck formation process by downregulating the lncRNA Neat1, and experimentally confirm that the entry of NiCo NCs into cells is required for the observed inhibition of inflammasome activation. Furthermore, we find that NiCo NCs inhibit neutrophil recruitment in an acute peritonitis mouse model and relieve symptoms in a colitis mouse model, again by inhibiting inflammasome activation. Beyond demonstrating a highly surprising and apparently therapeutic impact for an inorganic nanomaterial on inflammatory responses, our work suggests that nickel- and cobalt-containing nanomaterials may offer an opportunity to design anti-inflammatory nanomedicines for the therapeutics of macrophage-mediated diseases.

Simulation of peritoneal sepsis and its treatment with serum in an experiment: peculiarities of morphological disorders of liver, spleen and kidney tissues

Sepsis develops as a normal inflammatory response to various infections. It proceeds with the picture of a complex heterogeneous syndrome, which often leads to the development of multiple organ failure. The number of affected organs correlates with mortality. Organ failure is characterized by a sequence – initially pulmonary, then renal, cardiovascular, and in the terminal stage, there is a failure of the central nervous system function. The aim of the study was to model peritoneal sepsis in an experiment, develop a therapeutic serum as an analog of anti-reticular cytotoxic serum by O. O. Bogomolets (ACS), and investigate the therapeutic properties and specific morphological changes in the liver, spleen, and kidneys of septic and treated animals. To simulate peritoneal sepsis, laboratory mice were injected intraperitoneally with a solution of 10 % of filtered fecal suspension of guinea pig (from 0.05 to 3.0 ml), the level of the toxic dose at which all mice died was determined (0.35 ml of fecal suspension) after that lethal bloodletting was administered under thiopental anesthesia. Their spleens were removed, from which therapeutic serum was made. Guinea pigs of the experimental group were injected with a suspension of the spleen of mice with an increasing dose from 0.02 to 0.2 ml after the simulation of fecal peritonitis. The optimal therapeutic dose at which the ants continued to live for 14 days was determined: 0.08 ml. Under thiopental anesthesia (50 mg/kg), their liver, kidneys, and spleen were taken for histological studies. The processing of the obtained histological specimens was carried out according to generally accepted methods. Histological preparations were studied using an SEO SСAN light microscope. It was found that under conditions of peritoneal sepsis in the liver, the lobular organization of hepatocytes was dramatically disturbed. The central veins and vessels of the portal tracts were moderately dilated and filled with blood, but the lumens of the sinusoids were practically not visualized. The sizes of hepatocytes increased sharply, contours were erased, and intercellular connections were disrupted. Histological examination of the kidney revealed a drastic decrease in the blood volume in the vessels of the arterial bed, which is visualized by the structural manifestations in the cortical layer. Collaptoid shrinkage of glomerular vessels was observed, which manifested in their sharp reduction in size. A significant part of the endotheliocytes was damaged. Examination of the spleen revealed a significant increase in the area of the red pulp due to the pronounced expansion of the sinusoids and an increase in their blood supply. The white pulp exhibited small, moderately diffuse foci of lymphocyte clusters. Follicle structures were practically not visualized. Histological examination of the liver in animals with simulated peritoneal sepsis on the background of correction with an extract from the spleen of mice revealed a moderate expansion and full blood vessels of the portal tracts and central veins. The contours of the vast majority of hepatocytes grew clear, intercellular contacts were restored. Histological examination of the kidney revealed a moderate increase in the blood volume in the vessels of the arterial bed, mainly in the cortical layer. A mild expansion and fullness of blood vessels of the glomeruli was observed, which was manifested by their increase in size. An increase in macrophage-type cells was observed in the perivascular areas. Histological examination of the spleen revealed a pretty large area of red pulp, moderate expansion and fullness of the sinusoids, and pronounced perisinusoidal edema. However, a rapid expansion of the white pulp was observed, which manifested in the formation of follicles.