[Mortality in emergency abdominal surgery: apropos of 304 cases. An argument for clinical medicine]

Survey of 304 cases of surgical, abdominal emergencies (peritonitis and bowel occlusions). We deplored 42 post-operative deaths (14%). When patients are operated within 12 hours after the beginning of the pain, out of a group of 56 patients, two died (4%). After the 48th hour, of 114 patients operated, 26 died (23%) despite a stay in an intense care unit. 174 patients, under 60 years old, were operated; 4 died (2.3%). This is mainly due to a stay in an intense care unit (50 were operated after the 48th hour). Out of a group of 60 eighty years old patients, 18 were operated before the 24th hour; one death, that of a 94 years old patient, was deplored. Out of the 42 patients operated after the 24th hour, 19 died (45%). On the 304 patients, 56 (18%) were operated before the 12th hour, and 18 only, before the 6th hour (6%). The delay in operating, does not increase mortality only, but increase the duration of hospitalisation; this in itself increase expenses and sufferings. The causes of these delays are analyzed. A wiser use of clinical examination would decrease them.