Diagnosis and treatment of children with acute surgical diseases of the abdominal organs and acute intestinal infections

Introduction. The clinical manifestations of acute surgical diseases of the abdominal organs in children may be similar to acute intestinal infections. To date, there remains a need to optimize the therapeutic and diagnostic algorithm in children due to the emergence of “new” and expanding the range of rare nosologies of “acute abdomen” with atypical clinical manifestations of diseases for certain age groups of children.

Aim. To optimize the treatment and diagnostic algorithm for children with acute surgical diseases of the abdominal organs and acute infectious diseases.

Materials and methods. The study included 437 children with acute surgical diseases of the abdominal cavity and acute infectious diseases. All patients underwent examinations at the preoperative stage in accordance with the clinical protocol for the diagnosis and treatment of acute surgical diseases in children. The volume of surgical intervention was determined during laparoscopy. The average age of the patients was 10.23 ± 3.3 years. The prehospital period is 15.9 ± 8.5 hours. The preoperative period was 14.6 ± 7.6 hours. The coincidence of diagnoses at admission/clinical was 413/331 (80%).

Results and discussion. Three variants of clinical and instrumental manifestations of acute surgical diseases of the abdominal cavity in combination with acute intestinal infections in children have been identified. Reliable differences between individual indicators of clinical and anamnestic, instrumental and intraoperative data in groups of patients with acute surgical and infectious diseases have been proved.

Conclusion. The atypical course of acute abdominal symptoms in children from the younger age group is due to a predominance of systemic inflammatory responses over local symptoms in 30% of cases. It is justified to intensify diagnostic measures, such as expanding the indications for laparoscopy, in children from younger age groups.

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