Аннотация
Objective: Study of some mechanisms and course of bacterial translocation and disruption of the liver barrier function with subsequent correction in widespread purulent peritonitis. Patients and Methods: A retrospective and prospective study was conducted based on data obtained from the examination and treatment of 69 patients with widespread purulent peritonitis who were hospitalized in the surgical departments and the liver and pancreas surgery department of the Dushanbe City Emergency Medical Care Center. The study covered the period from 2014 to 2024. Results: According to the microbiological analysis, a high prevalence of gram-negative bacteria was noted: Escherichia coli was detected in 59 cases (85.5%) as a monoinfection and in 7 cases (10.1%) in combination with other microorganisms; Streptococcus faecalis was detected in 18 cases (26.0%) as a monoinfection and in 5 cases (7.2%) in combination with other bacteria. The highest sensitivity of bacteria to the most frequently used antibacterial agents was noted for meropenem and imipenem - in 86.9% and 86.2% of cases, respectively. All patients with widespread purulent peritonitis developed severe visceral circulation disorders: blood flow in the superior mesenteric artery decreased by 47.1±2.8%, 351.20±18.59 ml/min, total hepatic blood flow - by 57.1±2.5%, 680.30±38.42 ml/min, portal blood flow - by 71.3±2.2%, 332.20±26.22 ml/min, hepatic arterial blood flow - by 18.3±4.0%, 348.10±16.71 ml/min compared to healthy individuals, which indicated a severe disorder of organ hemodynamics in the liver and small intestine. Conclusion: In the pathogenesis of visceral function disorders in widespread purulent peritonitis, an important role is played by organ circulation disorders, massive translocation of intestinal microflora into the arteriovenous bed, and acute liver failure, manifested primarily by macrophage liver failure.