Appendicular-genital syndrome in the structure of "acute abdomen" in girls

Abstract

Inflammation of the appendages of the uterus as a separate pathology and in appendicular-genital syndrome (AGS) leads to a violation ovarian, histogematic and follicular barriers, which in the future can cause reproductive function disorders, primary infertility, menstrual cycle disorders, the development of adhesions in the pelvis, as well as pain syndrome. Purpose - to analyze the frequency of detection of ACS among the children's population; to draw the attention of medical personnel to this pathology. Materials and methods. In the period 2019-2022, to the Pediatric Surgery Clinic of the National Pirogov Memorial Medical University 310 patients with acute appendicitis and gynecological pathology were hospitalized. Of them, 227 (73.23%) girls were operated on for acute appendicitis, 70 (22.58%) patients had a gynecological problem. ACS was detected in 13 (4.19%) patients. Results. Specific weight AGS among monopathology of the appendix and uterine appendages was 4.19%. All children from AGS had abdominal pain syndrome at the time of hospitalization. Most of the patients had localization of the pain syndrome in the right pubic area and above the pubis. According to the ultrasound examination of pathological changes in the appendages of the uterus were noted in 10 (76.92%) patients, signs of inflammatory transformation of the appendix were observed in 5 (38.46%) patients. All children from AGS were operated. In 4 (30.77%) patients, surgical intervention was completed by removal of the uterine appendage due to tissue necrosis on the background of torsion. Conclusions. So, when pathology of the uterus and appendages and appendix were detected, it should be followed conductrevision of abdominal organs. According to clinical protocols and our judgment, it is necessary to remove the appendix in case of catarrhal changes in the wall of the appendix. Indications for adnexectomy are necrosis of uterine appendages, malignant neoplasms of uterine appendages. In doubtful cases, a diagnostic laparoscopy should be performed regarding the localization of the pathology focus. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of the children's parents was obtained for the research. No conflict of interests was declared by the authors.