Surgical Pathology of Abdominal Organs or Acute Intestinal Infections. Diagnostic Difficulties

Abstract

Introduction. The polyetiology and diversity of clinical manifestations of acute intestinal infections determine the difficulties of the differential diagnosis with acute surgical pathology of the abdominal organs.This study aims to elucidate the causes of the erroneous diagnosis of surgical pathology of the abdominal organs which have symptoms similar to acute intestinal infections.Materials and methods. The paper presents an analysis of 2940 medical records of patients hospitalised in the intestinal infections department of the Infectious Diseases Hospital No. 4 of Ufa with suspected acute intestinal infections. Among these in 42 patients following the clinical and laboratory examinations, the nature of the disease was established as a disorder requiring surgical treatment, and they were transferred — urgently, more often than not — to appropriate hospitals.Results and discussion. The authors identified the earliest and most informative clinical, anamnestic and laboratory parameters aimed at making a timely differential diagnosis of acute intestinal infections with a variety of surgical pathology of the abdominal organs, primarily with acute appendicitis, intestinal tumours, somatic diseases of the gastrointestinal tract, haemorrhagic fever with renal syndrome and myocardial infarction.Conclusion. When a non-infectious disease was diagnosed the authors carefully examined the results of general clinical tests, fecal panel, results of bacteriological and enzyme-linked immunosorbent assays of feces and vomit for pathogenic and opportunistic enterobacteria, rotaviruses, ultrasound and X-ray images of the abdominal organs.