Hemostatic disorders in acute progressive peritonitis 

Sheykh-Akhmed S. Al-Kubaysi, Candidate of medical sciences, senior lecturer of the sub-department of faculty surgery with courses in topographic anatomy and operative surgery, urology and pediatric surgery, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), shekhahmed88@yandex.ru
Aleksey P. Vlasov, Doctor of medical sciences, professor, head of the sub-department of faculty surgery with courses in topographic anatomy and operative surgery, urology and pediatric surgery, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), vap.61@yandex.ru
Nina A. Myshkina, Candidate of medical sciences, assistant of the sub-department of hospital therapy, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya  street, Saransk, Russia), 304ab@mail.ru
Tatyana N. Kumaksheva, Assistant of the sub-department of hospital surgery, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), tanya.kumaksheva@mail.ru
Evgeniya A. Khozina, Assistant of the sub-department of hospital surgery, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), eahozina@gmail.com
Denis A. Romanov, Applicant of the sub-department of faculty surgery with courses in topographic anatomy and operative surgery,  urology and pediatric surgery, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), vap.61@yandex.ru
Vladimir G. Shindakov, Postgraduate student, Medical Institute, Ogarev Mordovia State University (68 Bolshevistskaya street, Saransk, Russia), vap.61@yandex.ru

Background. In surgical practice, peritonitis remains one of the most serious diseases. The urgency consists of a high prevalence, fatal outcomes, a high probability of progression and development of serious complications. The purpose of the work is to study the state of the hemostasis system in patients with acute progressive peritonitis. Materials and methods. A prospective multicenter cohort study of patients with acute peritonitis was performed. In accordance with the goal, the patients were divided into 2 groups. The first (n=25) group – without complications, the second (n=14) – with the development of complications. Research methods – clinical, biochemical (assessment of liver function and the state of the coagulation system). The study dates are the 1st, 5th, 10th day of the postoperative period. Results. In the early postoperative period, patients with acute peritonitis have significant disorders of the hemostasis system, which are associated with changes in the functional status of the liver. When the phenomena of peritoneal inflammation are relieved, hemostasis indicators are restored. In the group of patients who have postoperative complications, mainly wound ones, the phenomena of hypercoagulemia and inhibition of fibrinolysis progress, which led to the development of deep vein thrombosis of the lower extremities in 3 patients (patients operated). In patients with acute peritonitis with progressive course (tertiary peritonitis, sepsis) there is a transformation of the state of the hemostasis system: hypocoagulation and hypofibrinolysis are recorded against the background of a sharp depression of the functional state of the liver. Conclusions. In patients with acute peritonitis, as the pathology progresses, large liver lesions occur, leading to serious disorders of the coagulation-lytic system and postoperative complications.

peritonitis, wound complications, thrombosis, liver, hemostasis, sepsis

Al-Kubaysi Sh.S., Vlasov A.P., Myshkina N.A., Kumaksheva T.N., Khozina E.A., Romanov D.A., Shindakov V.G. Hemostatic disorders in acute progressive peritonitis. Izvestiya vysshikh uchebnykh zavedeniy. Povolzhskiy region. Meditsinskie nauki = University proceedings. Volga region. Medical sciences. 2023;(1):14–24. (In Russ.). doi:10.21685/2072-3032-2023-1-2