[Surgical reoperations for postoperative peritonitis]

In our clinical study postoperative peritonitis represent 17.01% by operations for neglected peritonitis. The other abdominal complications are eviscerations, postoperative oclusions and residual abscesses.

We have to analize the incidence, etiology, diagnosis and surgical management of 25 cases by postoperative peritonitis which appears after operations of 147 cases by neglected peritonitis. The semiology of a postoperative peritonitis it is easy to recognize in young pacients with reactions which appear in a few days after operations : pain localised to the abdominal area well localised in an area in which palpation show contraction. In a few hours the pain became flow. It appears fever,nausea,vommiting and all the clinical signs of peritonitis.

The highest prevalence of postoperative peritonitis for which we perform reoperations it appears after appendectomy in 18 cases with fatality 11.11%; next are coming reoperations on stomac and duodenum 4 cases with rate of fatality by 50%, reoperations on small bowell in 2 cases with fatality by 50% and reoperations of big bowell (1 case). On our series of postoperative peritonitis we have a global rate of fatality by 20% from all cases. We have considered this level well in comparison with the dates from another similar experience which show us a rate of fatality which are gone until 90%. Our media of reoperations were about three operations on each cases. If we compare with first operation for neglected peritonitis we have observe that in reoperations we change our plans in the way of making faster minimum necesary because of high risk to dead of this cases.

Clinical diagnosis by postoperative peritonitis is difficult to establish and only follow up very care clinical signs of this cases beneath laboratory findings (leucogram, uree, ionogram) and with radiological examination (CT) can tell us about postoperative peritonitis.