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[Importance of source control in secondary peritonitis]
Mehmet Mihmanli1, Birol Ağca, Ediz Altinli
1Sişli Etfal Eğitim ve Araştirma Hastanesi 3. Genel Cerrahi Kliniği, Istanbul. mmihmanli@yahoo.com
Aims:
In this study we discussed retrospectively secondary peritonitis patients, surgical treatment modalities and their effectiveness in our clinic.
Materials & Methodology:
91 patients were operated due to diffuse peritonitis between December 1998 through July 2001 in our clinic were analysed by age, sex, etiology of peritonitis, treatment modalities, morbidity and mortality.
Results:
32 patients were female (35.2%) and 59 patients were male (64.8%). The median age was 40.4. The most common etiologic factor for secondary peritonitis is peptic ulcus perforation (38.4%). 23 cases (25.2%) had the diagnosis only by physical examination and laboratory assessment. The other cases diagnosed with roentgenographic evaluation. In the first operation, the aim was the source control and eradication. In 3 cases, planned re-laparotomy "staged abdominal repair" (STAR) were performed. Conservative treatment modality was performed for 8 cases. The median hospital stay for the patients were 7.4 day. Morbidity was encountered in 13 (13.6%) and mortality was encountered in 2 (2.1%).
Conclusion:
Source control must be the primary aim of the first operation for secondary peritonitis patients. If there is an uncertainty for source control, STAR procedure should be the choice of the treatment modality for decrease morbidity and mortality.