[A 10-years experience in the treatment of the acute peritonitis]

The contemporary classification of the acute peritonitis, the etiology, the special features of the pathogenesis, the difficulties of the diagnostics with some of the kinds and the contemporary aspects of the healing tactics related to the clinical experience of the treatment of that severely and life-threatening disease are included in the present report for 10 years period. 341 laparotomies because of various kinds of peritonitis with patients aged 11-89 years old were performed at the Department of Surgery, University Hospital "Aleksandrovska" -Sofia for the period of 1996-2006. A diffusous fibrino-purulented peritonitis was founded out in most of the cases (41.6%) and the perforations constituted the most common etiologic cause. Total mortality is 25.8% (88 cases). The cause of death was not directly connected to the surgical suffering in 2.34% (8 cases). The death rate is high as expected with the groups of pregressed widespread peritonitis, the 3rd group by Mannheim peritonitis Index (MPI), the postoperative peritonitis, accompanied usually by atypical clinical features, for the elderly patients and patients with worsening the prognosis with premorbid pathology. A complex approach was applied not only for the peritonitis but also for the pathologic processes caused life-threatening complications. The applied treatment depends on the contemporary methods. The results are in accordance with those of the international experience.