COMPARATIVE CHARACTERISTICS OF THE MECHANISMS OF ENTERIC INSUFFICIENCY SYNDROME IN CANCER PATIENTS AFTER MULTIORGAN SURGERY AND IN CASE OF COMBAT TRAUMA

Summary. Increasing attention is being paid to the enteric insufficiency syndrome (EIS) in patients with traumatic injury (TI) and after multiorgan surgery, which plays an important role in the initiation and further development of multiple organ dysfunction syndrome (MODS), a systemic process mediated by endogenous and exogenous circulating factors, the action of which is not directly related to severe trauma. In victims with complicated CT and after multiorgan surgery in cancer patients, the intestinal tube can be a reservoir of pathogenic bacteria and infections. The reason for this is that bacteria, penetrating the mucosal barrier of the intestinal wall, can ultimately lead to sepsis. Materials and methods. In the course of the clinical trial, we examined 57 combat trauma victims (group 1) and 29 cancer patients after multiorgan surgical interventions (group 2). The selection criteria were the presence of enteric insufficiency syndrome in patients. Results of the study. Studying the pathogenetic mechanisms of enteric insufficiency in groups of patients, we came to the conclusion that it is advisable to divide them into three main links of pathogenesis: 1 link factors that caused the development of SEN 2 - circulatory disorders 3 - motor evacuation function disorders On ultrasound, the most consistent sign of enteric insufficiency syndrome was an increase in the diameter of the intestinal loops from 28 to 48 mm, detected in 79 patients (95.2%). Swelling and thickening of the intestinal wall up to 5 mm were detected in 75 cases (90.4%), deposition of a significant amount of fluid in the lumen of the small intestine was noted in 76 patients (91.6%), and, depending on the duration of the disease, the heterogeneous content (liquid-gas with uneven pneumatisation) in the early stages was replaced by a homogeneous hyperechogenic one with a predominance of fluid. Conclusions.Based on the results of the study, the main mechanisms of development of enteric insufficiency are: Microcirculatory disorders and coagulopathy in 67%. Hypoxaemia in multiorgan surgical interventions and multiple combat trauma was diagnosed in 71.2% of cases. Abdominal compartment syndrome in 38% of cases. Systemic inflammatory response syndrome was diagnosed in both groups, in victims with combat trauma in 69% of cases and in patients after multiorgan surgery in 34.9% of cases.