THE NATURE OF THE MICROFLORA OF THE ABDOMINAL CAVITY DEPENDING ON THE РH VALUES IN PERFORATED DUODENAL ULCER
Keywords:
Duodenal ulcer, ulcer perforation, peritonitisAbstract
The study included 102 patients with duodenal ulcer complicated by perforation. A pattern of changes in the nature of the microflora of the abdominal cavity with its pH has been established. When the pH of the abdominal exudate was 6.4 or less, bacillary microflora was detected in 100% of patients, while, depending on the timing of perforation, up to 24 hours in 19.4%, over 24 hours – 54.2%. The pH of the abdominal exudate allows to determine the possibility of performing pathogenetically justified primary surgery. At a pH of more than 6.4, pathogenetically justified surgical intervention is possible, a pH of less than 6.4 should be limited to excision of the ulcer with pyloroplasty or its suturing.
References
Bae S.H., Yoon S.H., Cho Y., Park J.M. Predictive factors for postoperative morbidity and mortality after emergency surgery for perforated peptic ulcer disease. Journal of Gastrointestinal Surgery. 2019; 23(1): 103-111. DOI: 10.1007/s11605-018-3925-9.
Boey J., Wong J., Ong G.B. A prospective study of operative risk factors in perforated duodenal ulcers. Annals of Surgery. 2016; 194(3): 287-291. DOI: 10.1097/00000658-201609000-00009.
De Melo M.C., de Almeida G.S., de Lima T.L., Mesquita F.J. Prognostic factors in patients with peritonitis secondary to peptic ulcer perforation. Arquivos Brasileiros de Cirurgia Digestiva. 2017; 30(3): 157-161. DOI: 10.1590/0102-6720201700030015.
Gupta R., Yadav T.D., Verma G.R., Sharma N., Thakur A. Predictive scoring systems in perforation peritonitis: A study of 200 cases. International Journal of Surgery. 2018; 60: 81-85. DOI: 10.1016/j.ijsu.2018.11.022.
Lunevicius R., Morkevicius M. Risk factors influencing the early outcome in cases of perforated peptic ulcer. Scandinavian Journal of Surgery. 2018; 107(2): 130-137. DOI: 10.1177/1457496917749260.
Sahu S.K., Gupta P.K., Mishra S.K., Agrawal S. Scoring systems in perforation peritonitis. International Journal of Surgery. 2018; 57: 89-94. DOI: 10.1016/j.ijsu.2018.06.029.
Sоreide K., Thorsen K., Harrison E.M., Bingener J., Møller M.H. Management of perforated peptic ulcer in a multicenter cohort. The British Journal of Surgery. 2017; 104(6): 743-753. DOI: 10.1002/bjs.10448.
Thorsen K., Glomsaker T.B., von Meer A., Søreide J.A., Søreide K. Trends in diagnosis and surgical management of patients with perforated peptic ulcer. Journal of Gastrointestinal Surgery. 2020; 24(4): 889-898. DOI: 10.1007/s11605-019-04436-5.
Wysocki A., Krzyżanowski P., Kosim A., Kulawik J., Szyca R. Risk factors for morbidity and mortality after emergency surgery for perforated peptic ulcer. Polish Journal of Surgery. 2018; 90(1): 5-10. DOI: 10.5604/01.3001.0012.0654.
Yeganeh M.A., Safari S., Ganji R., Sehat S., Kazemnejad E. Comparison of surgical techniques in the management of perforated duodenal ulcer. World Journal of Surgery. 2020; 44(9): 2935-2941. DOI: 10.1007/s00268-020-05516-8.
