PECULIARITIES OF THE COURSE OF ACUTE SEVERE PANCREATITIS COMPLICATED WITH ASCITES AND PERITONITIS

Acute pancreatitis is one of the most common diseases of the digestive system that often requires urgent admission to the hospital. Ascites and peritonitis in acute severe pancreatitis is a rather common complication of the early period of the disease. The evacuation of fluid rich in potentially toxic mediators from the abdominal cavity is advocated in a number of reports as an efficient measure to alleviate the burden of disease for patients in emergency condition. The purpose of the work was to analyze the effect of enzymatic ascites and peritonitis and drainage interventions performed on the course of acute pancreatitis. The study was based on the analysis of 44 case histories of inpatients with acute pancreatitis complicated with ascites and peritonitis who took the course of treatment at the surgical department of the M.V. Sklifosovsky Poltava Regional Clinical Hospital for 2013 – 2017. The patients were divided into two groups: the first group included individuals who were performed on surgical interventions for enzymatic ascites and peritonitis in the early period of the disease; the second group included he patients who only had a comprehensive conservative treatment according to the protocols for the treatment of acute pancreatitis. The obtained results confirm that resolving enzymatic ascites enables to avoid mortality in the early period of the disease associated with the increase of organ and multiorgan failure in patients with severe and extremely severe course of acute pancreatitis, and in some cases contributes to regression of the disease. Once the damage is in progression, to some extent it can provoke a more severe course of post-operative drainage due to the number of factors as a surgical trauma, or drainage as an entrance gate for infection.