[Changes in cellular immunity in patients operated for peritonitis]

Area of Science:

• Immunology
• Surgical Infections
• Critical Care Medicine

Context:

• Peritonitis, an inflammation of the peritoneum, presents varying degrees of severity, from local to diffuse and overflow.
• Cellular immunity plays a critical role in the host's response to peritonitis.
• Understanding immunological changes is vital for predicting disease course and guiding treatment.

Purpose:

• To investigate the relationship between the severity of peritonitis and alterations in cellular immunity.
• To determine the prognostic significance of cellular immunity status in peritonitis patients.
• To evaluate the optimal timing for immunocorrecting therapy in different peritonitis classifications.

Summary:

• Local peritonitis shows minimal cellular immunity changes, with adequate restoration in 3-7 days, indicating a favorable prognosis.
• Diffuse peritonitis exhibits more pronounced immunological changes, particularly on day 3, with a trend toward improvement by day 7.
• Overflow peritonitis is associated with the most significant and persistent cellular immunity deficits, correlating with severe disease and complications.

Impact:

• Adequate immune responses accelerate patient convalescence in local peritonitis.
• Immunocorrecting preparations, initiated on days 2-3, are recommended for diffuse peritonitis.
• Early immunocorrecting therapy from the start of treatment is essential for patients with overflow peritonitis to mitigate severe outcomes.