Anal manometry and total index of endogenous intoxication in the diagnosis of acute appendicitis

Abstract

The purpose of the study was to improve the effectiveness of the diagnosis of acute appendicitis in children through the use of anal manometry and the total index of endogenous intoxication. Materials and discussion of the study. The study on the measurement of anal pressure included 60 girls who were hospitalized in the surgical departments of the Vinnytsia Regional Children’s Clinical Hospital (Ukraine). Female children aged 3 to 17 years were examined. Abdominal pain, mainly in the lower extremities, was the main reason for seeking medical help. For anal manometry, patients were divided into three equal groups – 20 children each. The first group consisted of girls who were hospitalized with suspected acute appendicitis, but in the course of further examination and observation, acute surgical pathology was excluded. The second group included girls who underwent surgery for acute appendicitis. Girls of this group were not found peritonitis. The third group consisted of girls who underwent surgery for acute appendicitis and had peritonitis of varying severity. The study of endotoxicosis consisted of peripheral blood analysis in 400 children with suspected acute appendicitis, whose average age was 12.6 ± 1.2 years, resulting in a significant relationship between the level of endotoxicosis and the inflammatory process in the abdominal cavity. Research results. In the study, we have proven a significant direct proportional increase in the indicators of rectal sphincter tone and the level of endogenous intoxication in relation to the inflammatory process. Conclusions. Anal manometry method shown in the study clearly demonstrates the dependence of the tone of the rectal sphincters with the degree of spread of the inflammatory process. 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.