[Intra-abdominal lavage in the multimodal treatment of patients with acute diffuse peritonitis]

Study showed that the suggested method for appraising the severity of the inflammatory process makes it possible to decide whether peritoneal lavage is necessary in each concrete case. The authors examined 217 patients with acute generalized peritonitis (AGP). Four degrees of the risk of a severe course of AGP were distinguished conditionally. Patients with the first degree of risk do not need intraabdominal lavage. To remove the noted inflammatory changes in the peritoneum it was sufficient to cleanse thoroughly and drain the abdominal cavity and introduce antibiotics into it during complex treatment. Intraabdominal lavage is indicated for patients with the second degree of risk and with marked inflammatory changes in moderate circulatory changes. Abdominal lavage with peritoneostomy is indicated for patients with pronounced inflammatory (N = 3.8 cond. units) and microcirculatory disorders (Y = 0.2 cond. units). Peritoneal lavage is not indicated in patients (third and fourth degrees of risk) with considerable inflammatory (N = 4.04 cond. units) and microcirculatory disorders (Y = 0.4 cond. units).