ON THE QUESTION OF DIAGNOSIS OF ACUTE SURGICAL PATHOLOGY IN CHILDREN WITH INFECTIOUS HISTORY

In 2021 – 2024, 10 children with a diagnosis of emergency abdominal pathology were transferred from the Children’s Infectious Diseases Clinical Hospital to the surgical hospital of the Pediatric Center, which amounted to 0.78% of the number of children hospitalized during this period with urgent diseases of the abdominal organs. A confirmed diagnosis of intestinal infection – salmonellosis, was diagnosed in only 1 child. All the patients had an infectious history, paroxysmal abdominal pain, repeated vomiting, stool disorders, inflammatory changes in the blood test. 6 patients were admitted to the infectious diseases hospital from home, after a day of treatment and observation, 3 children were sent to the surgical hospital, the rest were treated with a diagnosis of enterocolitis from 2 to 5 days. At the onset of the disease, 40% of the patients contacted the admission and diagnostic department of the Pediatric Center; after the surgeon excluded acute surgical pathology, they were sent for treatment to the Children’s Clinical Infectious Diseases Hospital. Nine out of ten patients transferred from the CCIDH were operated. Complicated appendicitis in this group of patients was detected in 4 children, in 2 cases the operations were performed due to intestinal obstruction. 30% of the patients were young children; it is in this group of patients that the diagnosis of surgical pathology is difficult due to the anatomical and physiological features, the severity of intoxication symptoms, and the complexity of interpreting abdominal symptoms. Atypical localization of the appendix was detected in 2 patients with the clinical picture of an infectious disease. All the patients were discharged with recovery, there were no repeated hospitalizations to the surgical hospital. The article provides a scoring scale for assessing the totality of clinical symptoms, which can help the doctor establish the correct diagnosis and avoid diagnostic errors.

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