[Generalized suppurative peritonitis in patients with destructive forms of acute appendicitis]

The authors undertook comparative analysis of the results of treatment, the number and intensity of postoperative pyo-inflammatory complications, and the mortality rate in a group of 51 patients with generalized purulent peritonitis of appendicular origin in various methods of abdominal cavity cleansing: closed drainage of the abdominal cavity (group I, 10 patients); continuous peritoneal lavage (group II, 15 patients), cleansing of the abdominal cavity in stages (group III, 26 patients). Any type of cleansing did not exclude the development of purulent complications during treatment, the whose number grew with the increase in the period between the appendectomy and the onset of the disease. Complications developed in 23 patients (45%). Their frequency and intensity were, however, much less when the abdominal cavity was lavaged in stages, which enable the number of cases of adhesive obstruction and the formation of abscesses between the loops to be reduced markedly. A progressive septic process and poly-organic insufficiency were the main causes of death. The mortality rate was 30; 26.6 and 11.5%, respectively, in groups I, II, and III.