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Acute appendicitis and continuous peritoneal lavage

J Gjessing, P J Tomlin

    Anaesthesia and Intensive Care
    |November 1, 1976
    PubMed
    Summary
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    Continuous peritoneal lavage after appendicectomy significantly reduces complications in perforated appendicitis patients. This treatment, lasting 18 hours, involves using dialysate until the abdominal fluid is clear.

    Area of Science:

    • Surgical Innovation
    • Gastrointestinal Surgery
    • Infectious Disease Management

    Background:

    • Acute appendicitis with perforation is a serious surgical condition.
    • High morbidity and complication rates are associated with perforated appendicitis.
    • Standard treatment involves appendicectomy, but further interventions are explored to improve outcomes.

    Purpose of the Study:

    • To evaluate the efficacy of continuous peritoneal lavage in reducing morbidity and complications following appendicectomy for perforated appendicitis.
    • To assess the impact of immediate postoperative peritoneal lavage on patient recovery.
    • To determine the optimal duration and volume of peritoneal lavage in this patient cohort.

    Main Methods:

    • A series of 117 patients with acute appendicitis and perforation underwent appendicectomy.

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  • Continuous peritoneal lavage was initiated immediately after surgery.
  • Treatment involved approximately 40 liters of dialysate per patient over an average of 18 hours, continuing until effluent was macroscopically clean.

    • Main Results:

    • Continuous peritoneal lavage demonstrated a significant reduction in the morbidity rate.
    • The complication rate associated with perforated appendicitis was notably decreased.
    • The treatment protocol was well-tolerated, with lavage continuing until macroscopic cleanliness of peritoneal fluid was achieved.

    Conclusions:

    • Immediate postoperative continuous peritoneal lavage is an effective adjunctive therapy for perforated appendicitis.
    • This method significantly lowers complication rates and improves patient outcomes.
    • Peritoneal lavage offers a valuable approach to managing the infectious and inflammatory sequelae of perforated appendicitis.