Improving the efficiency of diagnosis of acute appendicitis in female children through the use of anal manometry and total index of endogenous intoxication

Abstract

The aim of the study was to increase the efficiency of the diagnostic process in children with abdominal pain by using anal manometry and the total index of endogenous intoxication. Research methods. 400 female patients with abdominal pain aged 3 to 17 years, on the basis of Vinnytsia Children’s Regional Clinical Hospital (Ukraine), were involved in the analysis of endogenous intoxication and anal pressure. Results. The study showed a clear proportional increase in the values of anal pressure and total index of endogenous intoxication in accordance with the extent of the inflammatory process in the abdominal cavity due to acute appendicitis. Conclusions. Having conducted a clinical study, which involved measuring the anal pressure of the sphincters in various pathologies of the abdominal cavity and pelvic organs, we can say about the feasibility of using this technique in the clinical practice of surgeons. The above method demonstrates a fairly high informativeness. Therefore, it can be used as an additional element of diagnosis in complex clinical cases, especially in girls with overweight, cases with atypical location of the appendix, and atypical course of the disease. This method clearly demonstrates the dependence of the tone of the rectal sphincters with the degree of spread of the inflammatory process in the abdominal cavity and pelvic cavity. An new approach to the interpretation of endogenous intoxication according to general blood analysis based on the value of the total index of endogenous intoxication allows to assess the severity of endotoxicosis, based on which it is possible to predict the form of pathology and timely choose the necessary treatment tactics. Exceeding the value of the proposed total index of endogenous intoxication of the body more than twice indicates the child has the level of endotoxicosis characteristic of destructive forms of acute appendicitis, exceeding the index more than 2.5 times indicates a possible complicated pathology in the form of peritonitis. The introduction of the developed total index of endogenous intoxication in the algorithm of acute appendicitis will improve the results of early diagnosis and predict the form of pathology and its nature in children.