Features of the course of peritonitis in gunshot wounds of the abdomen, taking into account sexual predilection

Justification. To date, peritonitis remains one of the most difficult problems of abdominal surgery. The causes of peritonitis can be various diseases and factors, including gunshot wounds to the abdomen. Gunshot wounds of the abdomen occur in 4.7–16.2 %, while it is noted that with the development  of such peritonitis, there is a rapid development of multiple organ failure. It is known that the hormonal background of men and women is different, as a result of which there is a different reaction to stress, which undoubtedly affects the course of the postoperative period. At the same time, issues related  to the peculiarities of the course of the immediate postoperative period in case of gunshot wounds  of the abdomen, related to sexual differences, are not sanctified in the literature.
Goal. To study the features of the course of peritonitis caused by gunshot wounds of the abdomen in the civilian population, taking into account gender differences. 
Materials and methods. The basis for the study was the medical institutions of a surgical profile, the Chechen Republic, Lugansk and Donetsk People‘s Republics, in which surgical care was provided to the civilian population during the period of hostilities. Medical records were used as primary documentation. The study is multicenter, retrospective. 76 patients from among the civilian population who were treated for peritonitis caused by gunshot wounds to the abdomen were involved in the work. There were 35 (46.0 %) female patients and 41 (53.9 %) male patients. The inclusion criteria were: the presence of a gunshot (bullet or fragmentation) penetrating wound localized in the mesagastric region, aged 18 to 59 years, having signs of peritonitis upon admission. Exclusion criteria: non-penetrating nature of the wound, abdominal injury caused by injuries other than gunshot, the presence of injuries to the head, chest, limbs., persons younger than 18 years and older than 59 years.
Results. Based on the results obtained, it was found that peritonitis caused by gunshot wounds  to the abdomen is accompanied by a fairly high percentage of complications and death. The main causes of death are purulent-septic complications, which is confirmed by the data reflected in the literature. At the same time, our studies have shown that complications in such peritonitis depend on gender, so, in the group of men, the number of complications and deaths was higher than in the group of women. All these issues require further investigation.
Conclusion. Peritonitis, which develops as a result of gunshot wounds to the abdomen, is characterized by a high percentage of complications and deaths, respectively, 27,6 % and 36,8 % of cases.  At the same time, the development of complications of fatal outcomes depends on gender. So, in the group of men, complications occur in 25,0 %, and mortality is 26,3 %. In the group of women, complications occurred in 2,6 % of cases, and mortality was 10,5 %.

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