[Treatment of diffuse peritonitis]

From study of the values of central and peripheral hemodynamics in 369 patients with peritonitis of the diffuse form, it may be concluded that they reflect objectively the degree of intoxication. A hypodynamic reaction of the blood-vascular system is a poor prognostic sign indicative of progressing peritonitis. Much significance is attached to morphological and microbiological study of the biopsy material of the parietal peritoneum, which allows judgement of the stage of peritonitis. Along with the traditional infusion and antibacterial therapy in peritonitis, UVI of autoblood and intravenous laser irradiation of the blood in stages IIA and IIB are applied. This should be followed by hemosorption which contributes to the active excretion of toxins from the organism. The authors recommend the method of programmed relaparotomy in stage IIB when there is a large amount of exudate with a collibacillary odour and a tendency to the formation of unterintestinal abscesses. Intraaortal infusion of medicinal agents is recommended in this clinical group marked by a tendency towards hypotension. In the group of 369 patients who underwent operation 112 (29.5%) died.