Appendix H

Surgical procedure    

Pathogenesis of acute peritonitis

(obligatory)

 

Aggressive, infected content has gotten into abdominal cavity

 

 

Inflammatory response        Activation of immune system, biological   into abdominal cavity            active substances,  hypothalamo-

(oedema, hyperemia,                  pituitary-adrenal axis

exudation)

 

Peritoneal   Hypoxia of    Multiplication   Released   Disturbances of  

exudate       bowel wall      of microbes    cathepsins     microcircu-

                                                                                             lation

 

 

                    Adynamic

                          ileus

 

 

Liquid                Microbes         Phenols,

sequestration     translocation     skatoles

                                              production

 

 

 

Hypovolemia                      Intoxication                    Lost control

                                                                             (resources depletion)

 

 

 

Septic shock and multiple organ failure Appendix K

 Algorithm of  hernias treatment

(obligatory)

 

 

Preoperative examination

 

 

Accompanying somatic  pathology

 

 

Decompensate  Subcompensate  Compensate          Absent

 

 

            Medicamentous

                 correction

 

           

   Result                           Result

 is negative                     is positive  

 

 

    Surgery is                                                  Surgical

contraindicated,                                            treatment

   surgical corset

                                           

 

                                                 Repair by local           Alloplasty

                                                       tissues