Research on acute abdominal inflammatory processes in children

On 23 February at 15:00 in a public session of the Doctoral Committee of Medicine at Rīga Stradiņš University, which will take place in the Hippocrates Lecture theatre (16 Dzirciema Street, Rīga), Astra Zviedre will defend her doctoral thesis “Correlation of Acute Appendicitis and Acute Mesenteric Lymphadenitis with Changes of Serum Cytokines in Children”.

The origin of abdominal pain in children might vary from stomach disorders to potentially dangerous cases associated with the need for emergency surgical intervention. All over the world, including Latvia, acute appendicitis (AA) and acute mesenteric lymphadenitis (AML) are among the most common acute abdominal inflammation processes attributed to children. Timely diagnosis and appropriate treatment are essential in the above mentioned cases.

The clinical course of acute appendicitis and acute mesenteric lymphadenitis is often similar, however, treatment strategies in both cases will probably differ. In the case of acute mesenteric lymphadenitis, treatment is conservative and immediate hospitalisation of the patient is not required. However, patients with acute appendicitis require immediate hospitalisation and surgical intervention.

For the first time diagnostic data of acute appendicitis and acute mesenteric lymphadenitis have been analysed in Latvia based on internationally recognised and proven laboratory techniques, clinical criteria and simplified radiological examinations in children aged 7 to 18. Additionally, the author studied the diagnostic significance of inflammatory markers of cytokine group and their relation to other diagnostic methods in the case of both diseases.

The data obtained during the study demonstrate significant differences in the results of various diagnostic methods in the case of acute appendicitis. The opposite situation is observed in the case of acute mesenteric lymphadenitis. The highest diagnostic accuracy was reached by defining the most essential inflammatory markers of cytokine group and their limits and combining them with other diagnostic methods.

The incidence of acute appendicitis complications and the number of negative appendectomy cases reflects the situation of the national health care system with regard to children with acute appendicitis. Therefore, the information obtained during the study could be useful in developing various diagnostic algorithms for emergency medical assistance units, paediatric surgeons, general practitioners and paediatricians in clinical practice.