Peculiarities of pyogenic inflammatory processes in uterine adnexes complicated by secondary appendicitis in girls
In order to improve diagnostics of complicated pyo-inflammatory diseases of uterine adnexes, we undertook comparative analysis of their clinical course. The patients were girls aged 14-17 (mean 16.0+-0.2) years with laparoscopically confirmed secondary appendicitis (group 1, n=20) and without it (group 2, n=46). In all the cases, the histological study revealed secondary inflammation in removed appendix. It was shown that secondary appendicitis is not accompanied by such classical symptoms as pain migration, vomiting, and nausea. However, patients of group 1 more frequently experienced pain concentration in the right half of abdomen involving hypochondrium (χ <sup>2</sup>=6.24; p<0.012; TMF, p=0.008). Objective clinical condition of the girls with pyo-inflammatory diseases of uterine adnexes significantly deteriorated in the presence of secondary appendicitis (χ <sup>2</sup>=4.86; p<0.028; TMF, p=0.017) which necessitated more active and faster surgical intervention. (χ <sup>2</sup>=10.53, p<0.005). Although these observations make it possible to suggest secondary appendicitis based on clinical symptoms in girls with pyo-inflammatory diseases of uterine adnexes, laparoscopy remains the sole reliable method to diagnose this complication which emphasizes the necessity of active surgical treatment of these patients.