ANNOTATION
The work is devoted to improving the diagnosis, creating an algorithm for selecting methods of surgical treatment of liver and spleen abscesses.
Purpose: to improve the results of diagnosis and treatment of patients with abscesses of parenchymal organs of the abdominal cavity due to the differential approach to the choice of treatment based on the identification of features and prediction of the clinical course of this pathology.
The structure and level of morbidity of abscesses of parenchymal organs of the abdominal cavity are analyzed, and the increase in the frequency of detection of the latter in the population is established. The study included the results of examination and treatment of 183 patients with liver abscesses and 19 patients with splenic abscesses.
All patients were divided into 3 groups. Group I (n = 154) included patients for the treatment of which mini-invasive drainage techniques were used. The results of examination and treatment of 131 patients for 2006 – 2016 were studied retrospectively, by analyzing medical histories, ultrasound data (ultrasound) and computed tomography (CT) images, radiographs, electronic database of patients. These patients were included in subgroup I-a. 23 patients studied prospectively for the period 2016 – 2019, treatment was carried out using their own supplemented methods and techniques. These patients formed subgroup I-b. Group II (n = 31) included patients who underwent laparotomy and laparoscopic interventions. Group III (n = 17) consisted of patients with abscesses of parenchymal organs of the abdominal cavity, whose treatment did not require surgery.
Patients in these groups were compared by gender and age. The majority of patients (52.9%) were of working age, which determines the importance of the socio-economic component of the problem. No significant difference (p> 0.05) depending on gender was found.
To assess the diagnostic value of research methods, we analyzed the case histories of all operated patients, namely complaints on admission, examination results, characteristics of abscesses (lesion organ, location, size, structure, contour, relationship to surrounding structures and organs), obtained by ultrasound, CT, elastography, results of biochemical, microbiological and other laboratory tests.
