Abstract

Generalized acute peritonitis is defined as a brutal and diffuse peritoneum inflammatory.

AIM:

To assess the organic aspects of acute peritonitis of digestive origin and to evaluate the results of their surgical treatment.

MATERIAL AND METHOD:

Between January 1997 and December 2001, 221 patients were operated for generalized acute peritonitis. Among them, 207 patients (93.6%) had a digestive aetiology and were included in this study. They were 188 men (91%) and 19 women (9%). The average age of patients was 31.1 +/- 10.1 years old with extremes of 16 and 74 years. The organic (aetiologies) and therapeutic aspects as well as the remote follow-up were studied.

RESULTS:

The following aetiologies were found: perforation of gastro-duodenal ulcer, 109 cases (52.7%), complicated appendicitis, 76 cases (36.7%), ileal perforation, 13 cases (6.3%), colic perforation, 5 cases (2.4%), jejunal perforation, 1 case (0.5%), rupture of liver abscess, 1 case (0.5%) and pyo-cholecyst, 2 cases (0.9%). Complications had occurred among 65 patients i.e. 31.4% of the cases and were distributed as follows: local wound abscess, 42 cases (20.3%); evisceration, 10 cases (4.8%); post-operative peritonitis, 6 cases (2.9%); digestive fistula, 4 cases (2%) and resumption of ileostomy, 3 cases (1.4%). Mortality concerned 19 patients and the rate was 9.1%. Aetiology of death was septic shock or multiorgan failure in most of cases. The average time in which the continuity of the digestive tract was restored after stoma was 36.3 +/- 10.7 days. The late complications were: incisional hernia in 7 cases (3.5%), small bowel obstruction in 3 cases (1.5%) and pylorus stenosis in 1 case (0.5%).

CONCLUSION:

The perforations of gastro-duodenal ulcers, in first, followed complicated appendicitis are the most frequent aetiology. Mortality and morbidity, especially in parietal peritonitis, are not negligible.