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Cirugía paraguaya

versión On-line ISSN 2307-0420

Resumen

SAMANIEGO, Castor; RODRIGUEZ, Cynthia; LACONICH, Diego  y  FLORES, Jorge. ACUTE GENERALIZED PERITONITIS: CLINICAL FEATURES, ETIOLOGY AND PREOPERATIVE DIAGNOSIS. Rev. Cir. Parag. [online]. 2012, vol.36, n.1, pp.10-14. ISSN 2307-0420.

Background: Acute and generalized peritonitis (AGP) is a frequently observed disease. There are many associated etiologic factors and its early diagnosis improves treatment outcomes. Being acquainted with the main etiologic factors makes a better recognition of the clinical features and rational therapeutic approach. Patients and method: 229 patients with AGP that underwent laparotomy at the First Department of Surgical Clinics during the 2000- 2004 period (125 males and 104 females with a mean age of 39.8 years old) were retrospectively studied with the purpose of reviewing the main causes, results of diagnostic evaluations and accuracy of preoperative diagnosis.Results: There were 225 patients with abdominal pain (generalized in 116). Physical evaluation showed abdominal pain in 194 patients (generalized in half of the patients); muscle guarding in 172 and peritoneal irritation in 154. Decreasing of bowel sounds was assessed in 91 patients and there were none in 50 patients. Douglas pouch was painful in 114 patients. In 64% leukocytes were out of range and neutrophilia was shown in 90, 3%. Perforated appendix was the cause in 60, 7 % perforation of the stomach and duodenum was the cause in 14.4%, small intestine in 7%, colon and gallbladder in 6% and female internal genital organs in 4%. Preoperative diagnosis was correct in half of the cases. Conclusions: Abdominal pain as sign and symptom was observed in most of the cases. Peritoneal irritation, muscle guarding and decreasing or absence of bowel sounds was described in the largest part of cases. Neutrophilia was present in all the cases, even if leukocytosis was not. Preoperative diagnosis was correct in half of the cases.

Palabras clave : Generalized peritonitis; causes of peritonitis; diagnosis of peritonitis.

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