Peculiarities of differentiating surgical pathology of the abdominal cavity and pelvic organs in girls using ultrasound

Abstract

The issue of acute appendicitis remains extremely relevant today, as it is the most common inflammatory disease of the abdominal cavity. Despite significant advances in pediatric surgery in recent decades, when mortality from acute appendicitis is an exceptional event, the number of complicated forms in children is observed in 26.4% of cases, and morphologically unconfirmed appendectomies in 8.8% of cases. In girls, the rates are higher at the age of ≤10 years. Acute appendicitis has been and remains a very common disease in underdeveloped countries. In industrialized countries, the incidence of acute appendicitis ranges from 4-6% to 12-23%, in Ukraine - 20-21 cases per 10 thousand population, mostly young people.

Purpose - to state the peculiarities of differentiation of surgical pathology of the abdominal cavity and pelvic organs in girls using ultrasound examination; to develop an algorithm for diagnosing surgical pathology in girls.

Materials and methods. The study was conducted on the basis of the at the Vinnytsia Regional Children's Clinical Hospital, National Pirogov Memorial Medical University (Vinnytsia, Ukraine) for the period 2019-2021. For visual differential diagnosis, girls aged 4-16 years were involved in the study: 100 healthy children (the Group 1), 100 children diagnosed with acute phlegmonous appendicitis (the Group 2), 100 children with bulky uterine appendages of various types of pathology (the Group 3).

Results and conclusions. The following advantages of ultrasound have been established: high specificity of the study, low cost and absence of ionizing radiation. Ultrasound of the abdominal cavity makes it possible to diagnose acute surgical and gynecological pathology, as well as to carry out differential diagnosis of diseases simulating acute appendicitis. An algorithm for diagnosing surgical pathology in girls has been developed. Such an algorithm increases the effectiveness of ultrasound of acute appendicitis and neoplasms of the pelvic cavity, and this allows the doctor to establish the correct diagnosis in time and choose the appropriate treatment tactics.

The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.

No conflict of interests was declared by the authors.