Journal of Volgograd State Medical UniversityJournal of Volgograd State Medical University1994-94801994-9499Volgograd State Medical University11968610.19163/1994-9480-2021-3(79)-128-132Research ArticleSYNDROME INTESTINAL INSUFFICIENCY IN THE PATHOGENESIS OF ABDOMINAL COMPARTMENT-SYNDROME IN PATIENTS WITH ACUTE DESTRUCTIVE PANCREATITISKlimovichI. Nklimovichigor1122@yandex.ruMaskinS. S-ShevcovM. N-GolbrahV. A-FSBEI HE "Volgograd State Medical University" of the Ministry of Healthcare of the Russian Federation1503202118312813219122022Copyright © 2021, Klimovich I.N., Maskin S.S., Shevcov M.N., Golbrah V.A.2021The syndrome of intestinal insufficiency (SII) in patients with acute obstructive pancreatitis (ADP) leads to the formation of intra-abdominal hypertension (IAH), and then to the development of abdominal compartment syndrome (ACS) with all its inherent symptoms: acute heart, lung and kidney failure. Objective: to determine the role of SII in the development of abdominal compartment syndrome in patients with ADP. Materials and methods. Clinical studies were conducted in 71 patients with sterile pancreatic necrosis. Pathoanatomical studies of the small intestine were performed in 20 patients who died due to sterile pancreatic necrosis, of which 10 (50 %) died without SII and 10 (50 %) with SII. Results and discussion. SII developed in 57 (80 %) patients. Absolute quantitative and chronological relationships between SII and IAH and subsequent development were found in 11 (15 %) patients with ACS. SII was ahead of the formation of IAH by an average of 24 hours. IAH and, accordingly, ACS were not formed in patients without SII. The data of enterometry in the deceased with and without SII fully confirmed the results of clinical studies on the leading role of intestinal insufficiency in the development of IAH. Conclusions. SII is the initial and main link in the pathogenesis of the formation of IAH and the subsequent development of ACS in patients with ADP.intestinal insufficiency syndromeabdominal compartment syndromeintra-abdominal hypertensionintra-abdominal pressureсиндром кишечной недостаточностиабдоминальный компартмент-синдромвнутрибрюшная гипертензиявнутрибрюшное давление[Власов А.П., Трофимов В.А., Григорьева Т.И. и др. Энтеральный дистресс-синдром в хирургии: понятие, патогенез, диагностика // Хирургия. Журнал им. Н.И. Пирогова. -2016. - № 11. - С. 48-53.][Климович И.Н., Левченко С.А., Маскин С.С., Иголкина Л.А. Способ диагностики развития синдрома кишечной недостаточности у больных с абортивными формами острого панкреатита. Патент Рос. Федерации № 2547578. -13.03.2015.][Климович И.Н., Маскин С.С., Матюхин В.В. Синдром кишечной недостаточности у больных с острой абдоминальной хирургической патологией: монография. - Волгоград, 2019. - 147 с.][Клинические рекомендации «Острый панкреатит» // Минздрав РФ. - 2020. - 50 с.][Корымасов Е.А., Хорошилов М.Ю., Иванов С.А. Абдоминальный компартмент-синдром при прогнозировании молниеносного течения острого панкреатита // Инфекции в хирургии. - 2018. - Т. 16, № 1-2. - С. 50-51.][Manijashvili Z., Lomidze N., Akhaladze G., et al. Fasciotomy in the complex treatment of the abdominal compartment syndrome for pancreatic necrosis // Georgian Med News. 2019. - VoL. 40. - Р. 45-50.][Muresan M., Muresan S., Brinzaniuc K., et al. Negative pressure wound therapy of open abdomen and definitive closure techniques after decompressive laparotomy: a singlecenter observational prospective study. // Wounds. - 2018. -Vol. 8. - WNDS20180813-1.][Nassar T.I., Ounibi W.Y. AKI (respiratory, cardiovascular, and kidney) Associated with Acute Pancreatitis // Clin J Am Soc Nephrol. - 2019. - Vol. 14 (7). - Р. 1106-1115.][Stojanovic M., Svorcan P., Karamarkovic A., et al. Mortality predictors of patients suffering of acute pancreatitis and development of intraabdominal hypertension // Turk J Med Sci. 2019. - Vol. 49, no. 2. - P. 506-513.][Xu J.M., Yang H.D., Tian X.P.m et al. Effects of early hemofiltration on organ function and intra-abdominal pressure in severe acute pancreatitis patients with abdominal compartment syndrome // Clin Nephrol. - 2019. - Vol. 92. -Р. 243-249.][Zbar A.P., Wun L., Chiappa A., et al. Primary intraabdominal hypertension and abdominal compartment syndrome: pathophysiology and treatment // Emerg. Med. Open J. -2015. - Vol. 1., Iss. 2. - P. 46-63.]