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Related Experiment Videos

Aggressive treatment of severe diffuse peritonitis: a prospective study.

M Schein1, R Saadia, Z Freinkel

  • 1Department of Surgery, University of the Witwatersrand, Johannesburg, South Africa.

The British Journal of Surgery
|February 1, 1988
PubMed
Summary

This study explored an aggressive surgical approach for severe diffuse peritonitis, involving multiple staged laparotomies and leaving the abdomen open in some cases. While intensive, the strategy

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Area of Science:

  • Surgical Gastroenterology
  • Critical Care Medicine
  • Infectious Diseases

Background:

  • Diffuse peritonitis presents a significant challenge in intra-abdominal infection management.
  • Aggressive surgical strategies are sometimes employed for severe cases.

Purpose of the Study:

  • To evaluate an intensive management strategy for diffuse peritonitis using electively staged multiple laparotomies.
  • To assess the outcomes and feasibility of leaving the abdomen open in select peritonitis patients.

Main Methods:

  • Prospective study of 22 patients with severe intra-abdominal infections.
  • Inclusion criteria: massive faecal peritonitis, postoperative peritonitis, pancreatic abscesses.
  • Electively staged multiple laparotomies were performed, with the abdomen intentionally left open in 9 patients.

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Main Results:

  • The aggressive strategy was applied to only 9% of intra-abdominal infection patients over two years.
  • Patients required up to seven re-operations.
  • A high mortality rate of 32% was observed.

Conclusions:

  • The intensive management of diffuse peritonitis with staged laparotomies and open abdomens resulted in a high mortality rate.
  • The superiority of this aggressive approach over conventional methods remains unproven due to the high mortality observed.