[Treatment of perforated appendicular peritonitis]

The article analyses the results of treatment of 104 patients with generalized appendicular peritonitis. Sixty-four patients were admitted for acute disease and 40 patients for chronic disease. Twenty-three patients had been previously subjected to appendectomy for destructive appendicitis at other clinics. Among 100 patients who were operated on 60 were treated by appendectomy: cecostomy was established in 5 and ileostomy in 3 patients with incompetence of the stump of the vermiform process; in nonviability of the wall of the small intestine (11 patients) the wall was resected and an anastomosis formed in 7 and enterostomy was performed in 4 cases. The method of "closed evisceration" was employed in 24 patients with neglected forms of peritonitis. Thirty-three hemosorption sessions were conducted in 30 patients in the terminal stage of peritonitis. Four patients died in the preoperative period and 12 died after the operation. Seventeen complications were encountered after the operation: intestinal fistulas 4, abscess of Douglas' space 2, suppuration of wounds 5, and pneumonia 6.