Peritoneal lavage in appendicular peritonitis

Area of Science:

• Pediatric Surgery
• Infectious Disease Management
• Abdominal Surgery

Background:

• Peritonitis secondary to appendiceal perforation is a common pediatric surgical emergency.
• Complications such as sepsis and intra-abdominal adhesions can prolong hospital stay and increase morbidity.
• Optimal management strategies for peritonitis following appendiceal perforation are crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate the efficacy of peritoneal lavage in reducing hospital stay duration for children with peritonitis.
• To compare the incidence of septic and adhesive complications between antibiotic peritoneal lavage, antiseptic lavage, and no lavage.
• To assess the impact of antibiotic peritoneal lavage on residual intraperitoneal infection and the need for reoperation.

Main Methods:

• Retrospective analysis of 189 pediatric patients diagnosed with peritonitis secondary to appendiceal perforation.
• Comparison of outcomes including hospital stay, septic complications, adhesive complications, wound infections, and reoperations across different lavage groups (antibiotic, antiseptic, none).

Main Results:

• Peritoneal lavage significantly reduced the duration of hospital stay.
• Antibiotic peritoneal lavage led to a significant decrease in septic and adhesive complications compared to antiseptic lavage and no lavage.
• Fewer wound infections were observed in the antibiotic lavage group, contributing to reduced complications.
• The incidence of residual intraperitoneal infection was low, with no reoperations for sepsis in the antibiotic lavage group.

Conclusions:

• Peritoneal lavage is an effective adjunctive therapy for pediatric peritonitis secondary to appendiceal perforation.
• Antibiotic peritoneal lavage offers significant benefits in reducing complications and potentially preventing reoperations.
• Further prospective studies may be warranted to confirm these findings and optimize lavage protocols.