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Secondary peritonitis -evaluation of 204 cases and literature review

Abstract Hypothesis: Even at the beginning of the new millennium, secondary peritonitis presents a common life-threatening condition associated with high mortality and morbidity. Objective: This article comments on epidemiology, diagnosis and general principles of surgical management in patients wit...

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Autores principales: Doklestić, SK, Bajec, DD, Djukić, RV, Bumbaširević, V, Detanac, AD, Detanac, SD, Bracanović, M, Karamarković, RA
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Carol Davila University Press 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4197493/
https://www.ncbi.nlm.nih.gov/pubmed/25408716
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author Doklestić, SK
Bajec, DD
Djukić, RV
Bumbaširević, V
Detanac, AD
Detanac, SD
Bracanović, M
Karamarković, RA
author_facet Doklestić, SK
Bajec, DD
Djukić, RV
Bumbaširević, V
Detanac, AD
Detanac, SD
Bracanović, M
Karamarković, RA
author_sort Doklestić, SK
collection PubMed
description Abstract Hypothesis: Even at the beginning of the new millennium, secondary peritonitis presents a common life-threatening condition associated with high mortality and morbidity. Objective: This article comments on epidemiology, diagnosis and general principles of surgical management in patients with secondary peritonitis. Methods and Results: The demographic data, clinical findings and surgical outcome of 204 patients who had a confirmed generalized secondary peritonitis were analyzed retrospectively. Our approach was laparotomy, surgical control of contamination, antibiotic therapy and modern intensive care support. Acid peptic disease was the most common cause of perforation peritonitis 60 (29,41%), following by the perforated appendicitis 45 ( 22,06%). The faecal peritonitis and colon perforation were found in 42 patients (20,59%). The morbidity rate was 50%; 41 (40,2%) patients had more than one complication. The morbidity rate was significantly the highest in patients with colon perforation (n=38, 90%) (Hi-square=40,1; p<0,001). The overall mortality rate in our study was 8,82%. The mortality rate was significantly the highest among the patients with mesenteric ischemia in 4 patients (66,67%), followed by colon perforation in 10 cases (23,81%), and 4(6,6%) deaths due to gastro-duodenal perforation (Hi-square=45,7; p<0,001). Discussion: This study has confirmed that the clinical presentation and outcome of the secondary peritonitis depend on duration of abdominal infection, the site of perforation and the general condition of the patient. Rapid surgical source control, modern intensive care and sepsis therapy may offer the chance of decreased morbidity and mortality of the intra-abdominal infections. Abbreviations Intensive Care Unit (ICU), Perforated Diverticular Disease (PDD), Inflammatory Bowel Disease (IBD), Multiple Organ Dysfunction Syndrome (MODS), Acute Respiratory Distress Syndrome (ARDS), Nonsteroidal Anti-inflammatory Drugs (NSAID), Peptic Ulcer Disease(PUD), Ultrasonography (US), Computer Tomography (CT), Colorectal Cancer (CRC), Postoperative Adhesive Disease (PAD), Acute Mesenteric Ischemia (AMI).
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spelling pubmed-41974932014-11-18 Secondary peritonitis -evaluation of 204 cases and literature review Doklestić, SK Bajec, DD Djukić, RV Bumbaširević, V Detanac, AD Detanac, SD Bracanović, M Karamarković, RA J Med Life Review Abstract Hypothesis: Even at the beginning of the new millennium, secondary peritonitis presents a common life-threatening condition associated with high mortality and morbidity. Objective: This article comments on epidemiology, diagnosis and general principles of surgical management in patients with secondary peritonitis. Methods and Results: The demographic data, clinical findings and surgical outcome of 204 patients who had a confirmed generalized secondary peritonitis were analyzed retrospectively. Our approach was laparotomy, surgical control of contamination, antibiotic therapy and modern intensive care support. Acid peptic disease was the most common cause of perforation peritonitis 60 (29,41%), following by the perforated appendicitis 45 ( 22,06%). The faecal peritonitis and colon perforation were found in 42 patients (20,59%). The morbidity rate was 50%; 41 (40,2%) patients had more than one complication. The morbidity rate was significantly the highest in patients with colon perforation (n=38, 90%) (Hi-square=40,1; p<0,001). The overall mortality rate in our study was 8,82%. The mortality rate was significantly the highest among the patients with mesenteric ischemia in 4 patients (66,67%), followed by colon perforation in 10 cases (23,81%), and 4(6,6%) deaths due to gastro-duodenal perforation (Hi-square=45,7; p<0,001). Discussion: This study has confirmed that the clinical presentation and outcome of the secondary peritonitis depend on duration of abdominal infection, the site of perforation and the general condition of the patient. Rapid surgical source control, modern intensive care and sepsis therapy may offer the chance of decreased morbidity and mortality of the intra-abdominal infections. Abbreviations Intensive Care Unit (ICU), Perforated Diverticular Disease (PDD), Inflammatory Bowel Disease (IBD), Multiple Organ Dysfunction Syndrome (MODS), Acute Respiratory Distress Syndrome (ARDS), Nonsteroidal Anti-inflammatory Drugs (NSAID), Peptic Ulcer Disease(PUD), Ultrasonography (US), Computer Tomography (CT), Colorectal Cancer (CRC), Postoperative Adhesive Disease (PAD), Acute Mesenteric Ischemia (AMI). Carol Davila University Press 2014-06-15 2014-06-25 /pmc/articles/PMC4197493/ /pubmed/25408716 Text en ©Carol Davila University Press http://creativecommons.org/licenses/by/2.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review
Doklestić, SK
Bajec, DD
Djukić, RV
Bumbaširević, V
Detanac, AD
Detanac, SD
Bracanović, M
Karamarković, RA
Secondary peritonitis -evaluation of 204 cases and literature review
title Secondary peritonitis -evaluation of 204 cases and literature review
title_full Secondary peritonitis -evaluation of 204 cases and literature review
title_fullStr Secondary peritonitis -evaluation of 204 cases and literature review
title_full_unstemmed Secondary peritonitis -evaluation of 204 cases and literature review
title_short Secondary peritonitis -evaluation of 204 cases and literature review
title_sort secondary peritonitis -evaluation of 204 cases and literature review
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4197493/
https://www.ncbi.nlm.nih.gov/pubmed/25408716
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