MODERN APPROACHES TO THE DIAGNOSTICS AND SURGICAL TREATMENT OF ACUTE ABDOMINAL INFLAMMATORY DISEASES

Kivva Andrey Nikolaevich, Chubovskiy Andrey Ivanovich, Evlakhova Inessa Sergeevna, Zagreba Igor Vladimirovich

Acute abdominal inflammatory diseases (AAID) remain among the most pressing issues in modern abdominal surgery, requiring prompt diagnostics and surgical intervention. Despite significant advancements in diagnostic methods and surgical technologies, mortality rates for this pathology remain relatively high. This study presents a comprehensive analysis of modern diagnostic and therapeutic approaches for managing AAID patients, based on data collected at a Rostov-on-Don Municipal Emergency Aid Hospital spanning 2018-2023. A total of 876 patients with acute inflammatory diseases of the abdominal cavity were examined, primarily including acute appendicitis (42.3%), acute cholecystitis (28.7%), acute pancreatitis (15.2%), and other conditions (13.8%). The effectiveness of various diagnostic algorithms comprising laboratory tests, instrumental methods, and imaging techniques, was analysed. The outcomes of laparoscopic and traditional surgical interventions, as well as perioperative antibacterial therapy, were evaluated. The findings revealed that the implementation of a comprehensive diagnostic algorithm reduced the time required to establish a final diagnosis by 38.4%, and lowered the rate of diagnostic errors from 7.8% to 2.3%. Minimally invasive techniques reduced postoperative complications by 24.6% and shortened in-hospital stays by 3.7±0.8 days. An original prognostic scoring system was developed and implemented, demonstrating 89.4% sensitivity and 92.1% specificity in stratifying complication risks. The results highlight the necessity of a personalized approach to the selection of diagnostic strategies and surgical tactics for AAID, tailored to clinical and instrumental factors as well as the patient's comorbid background.

Keywords:Acute abdominal inflammatory diseases, surgical treatment, diagnostic algorithm, laparoscopy, antibacterial therapy, prognostic score, personalized approach.