[Postoperative complications in acute abdomen: prospective study of 586 patients]

Septic complications were prospectively studied in 586 consecutive adult patients operated for acute abdominal conditions. The purpose was to identify the postoperative infectious problems and to correlate such findings with diagnostic syndrome and with mortality. The investigation was performed in the period of January 1981 to October 1986 and a specific protocol was designed, with data about identification, diagnosis, surgical treatment, infectious and general morbidity, as well as mortality. The distribution according to symptoms at admission, shows the following conditions: inflammatory disease--72.2% of the population; obstruction of the gastrointestinal tract--13.5%; perforative manifestations--11.0%; hemorrhagic conditions--3.3%. There were 138 infectious complications after surgery (65.4%), as compared with only 73 non-septic ones (34.6%). A significant association between inflammatory and perforative symptoms and postoperative sepsis could be demonstrated, when compared with patients admitted and operated for obstruction or hemorrhage. Among the former cases, patients already exhibiting signs of peritonitis suffered the highest number of surgical wound infections and intra-abdominal abscesses. Thirty two patients died, 27 (84.4%) in consequence of sepsis. It is concluded that sepsis was the main cause of morbidity and mortality in this series. Although fatal cases were equally distributed among the different diagnostic groups, infectious complications occurred more often after surgery for inflammatory and perforative emergencies, than after obstructive or hemorrhagic symptoms.