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Post-Operative Peritonitis: Diagnostic Problems, Morbidity and Mortality in Developing Countries

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DOI: 10.4236/ss.2014.58059    4,065 Downloads   4,942 Views  

ABSTRACT

Goal: To study the diagnostic difficulties and post-operative morbidity and mortality of peritonitis. Patients and Methods: Retrospective study about the records of adult patients operated on between 1999 and 2013 whose diagnosis of post-operative peritonitis was made. Results: We achieved 23,573 lanterns and recorded 148 cases of postoperative peritonitis or 0.62%. The medium age was 37.1 ± 17.7 years and the sex ratio was 1.2. The delay between the initial intervention and reoperation was less than 5 days. Factors occurrence of postoperative peritonitis were those related to the initial surgery: septic context 70.8%, emergency surgery 81.1% under the seat mesocolic 25% and 20.3% initial surgical technique. The diagnosis was made preoperatively in 62.2% (n = 92). Ultrasound has found an effusion in 29.7% (n = 44). Cytobactériologic review identified germs in 85.1% (n = 126) and sterile in 12.9% of patients (n = 22). The most frequent etiologies were: 22.9% anastigmatic leak (n = 34), the phoenix abscess in 17.6% (n = 26), iatrogenic perforation 13.5% (n = 20) and digestive fistula 25% (n = 37). Other causes were the stoical necrosis 12.2% (n = 18) and evisceration 8.8% (n = 13). We performed a digestive stoma in 61% (n = 89), a closure of the abdomen bolsters in 8.8% (n = 13), a suture in iatrogenic perforation in 13.5% (n = 20) and washing with drainage in patients with phoenix abscess in 17.6% (n = 26). Morbidity was 22.3% and 53.4% mortality. Conclusion: The diagnosis of post-operative peritonitis is difficult in a developing country. Morbidity and mortality is high. Improved diagnostic tools are needed.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

Traoré, A. , Dembélé, B. , Togo, A. , Kanté, L. , Konaté, M. , Diakité, I. , Laurence, S. , Karembé, B. , Diarra, A. , Traoré, A. , Diango, M. and Diallo, G. (2014) Post-Operative Peritonitis: Diagnostic Problems, Morbidity and Mortality in Developing Countries. Surgical Science, 5, 363-367. doi: 10.4236/ss.2014.58059.

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