Alterations in Thyrotropic Hormone, Triiodothyronine, and Thyroxine in Patients Presenting Postoperative Diffuse Purulent Peritonitis

Abstract

This is a clinical study covering 55 persons of male sex with ages ranging from 25 to 55 years. The patients were divided up into 3 groups as follows: Group A, operated on for perforating gastroduodenal ulcer where the postoperative period ran a course free of any complications (18 patients); Group B, operated on for gastroduodenal ulcer, complicated by postoperative diffuse purulent peritonitis, with a successful cure as a final outcome (16 patients); Group C, operated on for perforating gastroduodenal ulcer, complicated by postoperative diffuse purulent peritonitis, with lethal outcome (21 patients). In all groups under study assessment was made of the levels of thyrotropic hormone (TTH), triiodothyronine (T₃), and thyroxine (T₄) at 1, 3, and 5 days after laparotomy in Group A, and after relaparotomy in Groups B and C. In the patients of Group A, the dynamic changes in TTH, T₃, and T₄ levels disclosed values within normal limits. In Group B, the levels of TTH and T₄ were within normal limits, while T₃ showed a low value during the first and third day, reaching the lowermost limit of the norm on the fifth day. In the patients of Group C, inhibition of the entire thyrotropin-thyroid axis was observed: TTH, T₃, and T₄ levels fell abruptly, with the change in T₃ being the most significant. These results suggest that the thyroid hormones may be related to these pathological conditions and that these hormones may be a good indicator for the prognosis of peritonitis.