Features of the clinical course and differential diagnostics of purulent- inflammatory diseases of the abdominal cavity against the background of type 1 diabetes mellitus in children

Annotation. Differential diagnosis of purulent-inflammatory diseases in the settings of type 1 diabetes mellitus (T1DM) in children still remains problematic due to the pain patterns and laboratory findings. The study aimed to improve the differential diagnosis of abdominal pain syndrome in purulent-inflammatory diseases of the abdominal cavity organs and diabetic ketoacidosis (DKA) in children by studying their prevalence, clinical and laboratory course, and assessing the integral index – neutrophil-lymphocyte ratio (NLR). The study included: group I (n=21) – patients with DKA and abdominal pain syndrome; group II (n=70) – patients with purulent-inflammatory diseases of the abdominal cavity – acute appendicitis, peritonitis; group III (n=11) – patients with purulent-inflammatory diseases of the abdominal cavity in the setting of type I diabetes mellitus (including DKA), who underwent a comprehensive clinical and laboratory examination, including calculation of the neutrophil-lymphocyte index. Statistical analysis was performed using the software package for statistical analysis STATISTICA v.10.0 (StatSoft, USA) and the open-code software – epidemic calculator – Epitools. The prevalence of purulent-inflammatory diseases of the abdominal cavity in the settings of T1DM was determined in the pediatric population of Vinnytska and Khmelnytska regions, respectively. The use of NLR was proved to be accessible, fast and simple test that can improve the differential diagnosis of purulent-inflammatory diseases of the abdominal cavity in children with DKA and/or T1DM. Further prospects for the development of this topic include cross-validation of the neutrophil-lymphocyte ratio value and an increase in the study sample with the assessment of the intensity of pain syndrome in the same areas of purulent-inflammatory diseases of the abdominal cavity and ketoacidosis.