Healing of enterotomies with preexisting peritonitis. An experimental study in guinea pigs

The question of whether the presence of peritonitis has any influence upon the process of healing and the load capacity of a standard enterotomy was studied in guinea pigs. Laparotomy was performed 4 h after induction of peritonitis by a standardized method. Fecal peritonitis could be confirmed clinically, histologically and bacteriogically in all cases. A standardized enterotomy was carried out. The animals were killed 3 or 5 days later, anastomoses inspected, and the intraluminal pressures for anastomotic rupture measured. Comparison with a control group showed: (1) there can be normal healing of an enterotomy even with coexisting peritonitis; (2) anastomotic breakdown takes place at the same pressure as in the control group (p less than 0.01), and (3) primary lethality is significantly higher in cases operated in the presence of peritonitis (33 vs. 20%).