[Possibilities of surgical treatment of diffuse peritonitis]

During 13 years 575 patients with various forms of generalized peritonitis were operated upon. The strategy of surgical treatment was determined depending on the kind of inflammation and the initial state of the patient. Mortality in semi-closed and semi-open strategy was 10.1% and 25.9% respectively. Mortality in cases with surgical complications after primary semi-closed strategy was 46.3% and the diagnostic time before the second operation was about 150 hours. An attempt to determine the prognosis of the development of complications and to work out recommendations on the strategy were made on the basis of the concept of the abdominal sepsis and using the APACHE II scoring system & Mannheimer Peritonitis-Index. The semi-open strategy was more preferable in the scores of APACHE II less than 11. The most effective method of intestinal decompression in suppurative peritonitis is total naso-intestinal decompression resulting in 29% less mortality.