The purpose of the research was to establish main causes of development and outcomes of adhesive obstruction.We analyzed the outcomes of treatment of 154 patients with acute intestinal obstruction. The following data were taken into consideration: age, gender, surgeries in past medical history, terms of adhesions manifestations, clinical symptoms, findings of additional examinations, methods of treatment, outcome. It has been established, that the most frequent causes of adhesions were appendectomy (23%), stomach operations (21 %) and gynecological interventions (14 %). After surgeries performed in conditions of regional hospitals, adhesions developed after appendectomy, gynecological operations and interventions on the intestine. In patients operated in city hospitals intestinal obstruction more often occurred after extensive operations on the stomach, appendix, and after gynecological interventions. Urgent surgical interventions more often led to adhesive process in the abdominal cavity (63 %). Mortality made 5.8 %. Causes of death were intestinal fistulas and abdominal sepsis.Thus, acute adhesive intestinal obstruction as an extreme form of abdominal adhesions continues to be an urgent medical issue.

The aim of the work was to establish the significance of complex bacteriological research in the diagnostics of acute appendicitis and to determine an optimal material for the research based on the findings. We examined 19patients with acute phlegmonous or acute gangrenous appendicitis (males, aged 18–60years). We performed bacteriological research of abdominal exudate (n=19) and biopsy specimen (n=19) of appendix wall taken before opening the lumen of the intestine. Both abdominal exudate and appendix wall specimen were taken at the same time. Aerobic and anaerobic microorganisms were detected and identified, antimicrobial susceptibility was tested. In total, we detected 25 strains of aerobic and 13 strains of anaerobic microorganisms. It has been established that a bioptate was most informative for testing (68.4 %); the parallel study of an abdominal exudate gave positive results in 21.1 % of cases. In the structure of clinically significant microflora dominated E.coli (43.3%), then went nonfermentative gram-negative bacteria (13.3%) and Bacteroidesspp. (16.7%). We marked growing resistance of detected strains of gram-negative bacteria to some antibiotics. For instance, 62 % of detected E.c oli strains were resistant to ampicillin, 25 % – to ciprofloxacin. 92 % of strains were resistant to cefepime, 93 % – to ceftriaxone, 77 % – to Amoxiclav, 67 % – to gentamicin, 90 % – to tobramycin. From one bioptate a strain of E. coli ESBL was separated. The study of intraoperative bioptate of appendix wall increases effectiveness of microbiological diagnostics in com-parison with the abdominal exudate research.