[Mortality in acute peritonitis as revealed by postmortem examination findings]

Acute peritonitis has been found present on 512 out of 4303 serial postmortem examinations performed over the past 10 years in the city of Izhevsk, giving the overall rate of 11.9%, but the rates were higher in older age groups. The conditions more commonly complicated by peritonitis were inflammatory and neoplastic diseases of abdominal organs. In 47% of the cases, peritonitis developed postoperatively, predominantly as a result of incompetence of anastomotic suture lines. In 26.9% of the cases, the peritonitis was not recognized during the patient's life, and in a majority of these it was in an early phase of development. The nature and extent of peritonitis varied both with the bodily reactivity and with the site and duration of the peritonitis itself. The peritoneal inflammations arising in inflammatory destructive conditions were generally of short duration and serous or serofibrous in type, whereas those of neoplastic or other origins were longer-lasting and displayed a purulent exudate. In cases where the peritonitis was in an early phase, the immediate causes were more diverse and included, in addition to intoxication (detailed mechanisms of which remain undisclosed), shock, thromboembolism, hepatorenal or cardiovascular failure, sepsis, and hemorrhage.