Journal of Osh State University. Medicine
Journal of Osh State University. Medicine
e-ISSN 1694-8831
DOI: 10.52754/16948831
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Current approaches to the management of systemic inflammatory response syndrome in peritonitis of various aetiologies

Meder Ergeshbaev, Ismatilla Ydyrysov, Omurbek Kurbanbayev

Received 27.02.2025, Revised 16.05.2025, Accepted 16.06.2025

Abstract

Systemic inflammatory response syndrome (SIRS) in diffuse peritonitis remains one of the leading causes of multiple organ failure and high mortality, making the search for effective methods of its management a priority in clinical practice. The purpose of the study was to assess the effectiveness of a newly developed comprehensive approach to the management of SIRS in patients with diffuse peritonitis of various aetiologies. The surgical treatment outcomes of 46 patients treated at Osh City Clinical Hospital between 2021 and 2023 were analysed (20 with postoperative peritonitis, 22 with perforated gastric or duodenal ulcers, and 12 with complicated appendicitis). The treatment protocol included regional antibiotic lymphotropic stimulation, systemic antibacterial and detoxification therapy, immunocorrection with roncoleukin, and early enteral nutrition (EEN). Clinical manifestations of SIRS and laboratory markers (leukocyte count, leukocytic intoxication index, and procalcitonin) were evaluated. Preoperatively, all patients exhibited three to four signs of SIRS. Following implementation of the comprehensive treatment protocol, there was a consistent and marked reduction in the frequency of clinical manifestations and laboratory marker levels in cases with favourable progression. In the ulcer perforation group, 17 of 22 patients had only two SIRS signs by the 3rd day, and by days 9 to 10 the signs were absent. In appendicular peritonitis, clinical symptoms decreased by days 3 to 6, and by days 9 to 10 most of the 12 patients retained an average of two signs. The slowest improvement was observed in postoperative peritonitis, although by days 6 to 10 the number of signs was reduced to isolated cases. A parallel decrease in leukocytosis, leukocytic intoxication index, and procalcitonin was recorded in favourable cases. The findings support the feasibility of incorporating regional antibiotic lymphotropic stimulation in combination with immunocorrection and EEN into treatment protocols for diffuse peritonitis to effectively manage SIRS


Keywords:

multiple organ failure; surgical infection; immunomodulation; antibacterial therapy; procalcitonin; leukocytic intoxication index; early enteral nutrition

https://doi.org/10.52754/16948645_2025_4(1)_39

Retrieved from Vol. 4, No. 1, 2025

Pages 39-47

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Suggested citation

APA
Ergeshbaev, M., Ydyrysov, I., & Kurbanbayev, O. (2025). Current approaches to the management of systemic inflammatory response syndrome in peritonitis of various aetiologies. Journal of Osh State University. Medicine, 4(1), 39-47. https://doi.org/10.52754/16948645_2025_4(1)_39
Vancouver
Ergeshbaev M, Ydyrysov I, Kurbanbayev O. Current approaches to the management of systemic inflammatory response syndrome in peritonitis of various aetiologies. J Osh State Univ Med. 2025;4(1):39–47. doi:10.52754/16948645_2025_4(1)_39