[Physiopathological and anatomo-clinical study of peritoneal irrigation in generalized acute peritonitis]

The objects of peritoneal wash-out and the conditions of its efficacy in acute generalised peritonitis were first defined. The authors then report the results of their physio-pathological research. The rules of intra-peritoneal wash-out then laid down. They suggest a method of wash-out perfectly adapted to the infected peritoneum. Study of the washings provides valuable information. The appearance, bacteriology and rate of wash-out, lead one to define criteria of prognosis which are useful and reliable for later treatment. These criteria may be grouped in a triad which are of value in addition to the clinical signs. The pathological consequences are then discussed. In the immediate post-operative period, there is no noxious effect on intestinal sutures, which can be attributed to the wash-out in this series of 20 cases. In the long-term, the absence of adhesions with restitutio ad integrum of the peritoneal cavity, was noted in 4 patients, and verified later by operation. The physiopathological basis and criteria of efficacy suggest that peritoneal wash-out should be used more often in modern treatment.