[BACTERIAL PERITONITIS HIGH VOLUMEN LAVAGE TREATMENT]

OBJECTIVE: To better define appropriate management of patients with disseminated purulent peritonitis using GREAT VOLUME PERITONEAL LAVAGE (GVPL).DESIGN : Prospective, comparative study.SETTING : "JOSE CASIMIRO ULLOA" Emergency Hospital, Lima Per .PATIENTS: 50 adult patients with disseminated purulent peritonitis plus feces in peritoneal cavity, which were operated using GVPL. Previously we evaluated 100 cases of the same disease operated without GVPL, in order to compare with our new results. INTERVENTION: All patients received pre-operative antibiotics, exploratory laparotomy was done to solve the cause of peritonitis, using a mean of 26 liters (20-42) of sterile lukewarm water for peritoneal lavage, to retire the pus and the fibrin adhered to intestinal surface.MAIN OUTCOME MEASURES: GVPL may be a definitive surgical solution for cases of disseminated purulent peritonitis.RESULTS: The 50 patients treated with GVPL were operated only one time and did not present post-operative surgical complication, the hospital stay was diminished.The 100 patients operated before we started this study presented 3% mortality, 81% morbidity and 19% were re-operated. CONCLUSIONS: GVPL method is the best surgical way to cure patients with disseminated purulent peritonitis.