EXPERIMENTAL AND MORPHOLOGICAL JUSTIFICATION OF THE ENTERAL INSUFFICIENCY DEVELOPMENT IN ABDOMINAL SEPSIS
Authors: Romanovskyy Mykola , Polyovyy Victor 
Published: March 2024

Abstract. Abdominal sepsis continues to remain the most frequent and formidable complication that complicates the course of acute surgical diseases of the abdominal cavity in 15-25 % of cases, and the mortality rate in various forms of peritonitis, depending on the form and its spread, is from 4 % to 60 %, reaching 90 % in postoperative peritonitis.The aim of the study. To study the dynamics of morphological changes of internal organs in animals with simulated acute diﬀ use peritonitis, depending on the stage of the inﬂ ammatory process of the peritoneum.Material and methods. The object of experimental research was 54 white sexually mature non-linear rats weighing 0.18-0.20 kg, kept in the vivarium of the Bukovinian State Medical University, which were divided into two groups. The main group consisted of 28 animals that were simulated with abdominal sepsis. Control group – 26 intact rats. All animals had free access to food and water. Abdominal sepsis in rats was modeled according to our proposed method, which consisted in infecting the peritoneal cavity with the contents of the hollow organs of the abdominal cavity. Animals were removed from the experiment on 1, 3, and 7 days of simulated peritonitis by decapitation under thiopental anesthesia.The results. On the ﬁ rst day of simulation of peritonitis in the animals of the main group, a histological examination of the peritoneum revealed focal purulent peritonitis with damage to the parietal peritoneum. Diﬀ use hyperemia, focal edema of the connective tissue, which is most developed in the submesothelial layers, was observed. Areas of swollen connective tissue contain a slight but diﬀ use mononuclear inﬂ ammatory inﬁ ltrate. We did not detect morphofunctional changes in the liver and kidneys of animals of the main group on the ﬁ rst day of experimental peritonitis. However, already on the third day of the study, the structure of the liver lobe was only partially preserved. The central veins were well visualized, slightly dilated, and contained a small number of erythrocytes. Changes were also found in the lung tissue of animals with peritonitis: enlarged alveoli and congestion of small vessels and hemorrhages. Hemorrhagic syndrome is not excluded as an early manifestation of acute pulmonary insu ﬃ ciency. On the seventh day, the structure of the liver lobe was signiﬁ cantly disturbed in the animals. The central veins were well visualized, slightly dilated and contained a large number of erythrocytes. Sinusoids were not visualized in the vast majority of ﬁ elds of view, sometimes they were detected only centrilobularly. The beam organization of hepatocytes was disturbed throughout the size of the lobule. During the histological examination of the kidney tissue of the animals on the 7th day of Клінічна анатомія та оперативна хірургія – Т. 22, № 4 – 2023 27 the experiment, we observed that in the cortical layer of the kidney, the glomeruli were somewhat enlarged and dilated, their vessels were ﬁ lled with blood, serous exudate was observed in the lumens, and individual glomeruli were shrunken and collapsed. The vessels of the venous bed were somewhat dilated, full of blood, and small perivascular spot hemorrhages were visualized.Conclusion. Morphological changes occur already during the reactive phase of abdominal sepsis and indicate the stages of multiple organ failure syndrome.