Post-Operative Peritonitis: Diagnostic Problems, Morbidity and Mortality in Developing CountriesReportar como inadecuado

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Goal: To study the diagnosticdifficulties and post-operative morbidity and mortality of peritonitis.Patients and Methods: Retrospective study about the records of adult patientsoperated on between 1999 and 2013 whose diagnosis of post-operative peritonitiswas made. Results: We achieved23,573 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 delaybetween the initial intervention and reoperation was less than 5 days. Factorsoccurrence of postoperative peritonitis were those related to the initial surgery: septic context70.8%, emergency surgery 81.1% under the seat mesocolic 25% and 20.3% initialsurgical technique. The diagnosis was made preoperatively in 62.2% n = 92.Ultrasound has found an effusion in 29.7% n = 44. Cytobactériologic reviewidentified 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, thephoenix abscess in 17.6% n = 26, iatrogenic perforation 13.5% n = 20 anddigestive 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 abdomenbolsters in 8.8% n = 13, a suture in iatrogenic perforation in 13.5% n = 20and washing with drainage in patients with phoenix abscess in 17.6% n = 26.Morbidity was 22.3% and 53.4% mortality. Conclusion: The diagnosis ofpost-operative peritonitis is difficult in a developingcountry. Morbidity and mortality is high. Improved diagnostic tools areneeded.

Autor: Alhassane Traoré, Bakary Tientigui Dembélé, Adégné Togo, Lassana Kanté, Madiassa Konaté, Ibrahima Diakité, Simo Notue Fab



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