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Management of generalized faecal peritonitis--can we do better?
J H Scholefield1, A Wyman, K Rogers
1University Department of Surgery, Northern General Hospital, Sheffield.
Journal of the Royal Society of Medicine
|November 1, 1991
Summary
Generalized faecal peritonitis has high mortality. This preliminary study suggests that laparotomy with repeated abdominal lavage and debridement may improve outcomes for patients with this severe condition.
Area of Science:
- Surgical Gastroenterology
- Critical Care Medicine
Background:
- Generalized faecal peritonitis carries a mortality rate exceeding 50%.
- Recurrent intra-abdominal sepsis contributes to high morbidity and mortality despite advances in intensive care.
Purpose of the Study:
- To investigate the efficacy of laparotomy, repeated abdominal lavage, and debridement in managing generalized faecal peritonitis.
- To determine if this surgical approach can improve patient outcomes.
Main Methods:
- A preliminary study involving six patients with generalized faecal peritonitis.
- Patients underwent laparotomy, repeated abdominal lavage (mean 20 lavages per patient), and debridement.
- Mean intensive care unit (ICU) stay was 8 days.
Main Results:
- Five of the six patients recovered and were discharged from the hospital.
- One patient died due to pre-existing renal failure and sepsis.
- The intervention was associated with a survival rate of 83% in this small cohort.
Conclusions:
- Laparotomy, repeated abdominal lavage, and debridement show potential in reducing morbidity and mortality in generalized faecal peritonitis.
- Further research is warranted to validate the effectiveness of this treatment strategy.