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Cirugía paraguaya
On-line version ISSN 2307-0420
Abstract
RODRIGUEZ, Cynthia; ARCE ARANDA, Carlos and SAMANIEGO, Castor. Peritonitis aguda secundaria. Causas, tratamiento, pronóstico y mortalidad.: Acute generalize peritonitis. Causes, treatment, prognosis and mortality.. Rev. Cir. Parag. [online]. 2014, vol.38, n.1, pp.18-21. ISSN 2307-0420.
ABSTRACT Background: Acute secondary peritonitis (ASP) is a common emergency, its fundamental treatment is surgical intervention, whoever despite the advances on surgical techniques, antibiotic-therapy and intensive care support; mortality and morbidity stay high, while its management remain difficult and complex. Patients and method: 99 patients with ASP, that underwent laparotomy at the First Department of Surgical Clinics, during the 2006-2010 period (56 males and 43 females) were retrospectively studied with the purpose of identify the main causes, establish the accuracy of preoperative diagnosis, investigate postoperative complications, evaluate prognosis factors of mortality according to the Mannheim index and determinate the mortality. Results: Perforated appendix, was the cause in 19%, follow by postoperative peritonitis (17%), in third place, perforation of the stomach and duodenum and small intestine (16%, each), follow by female internal genital organs (12%) and perforation of the colon (10%). The main treatment was controlling the local point of contamination, with primary close of the peritoneal cavity (93%), Open abdomen contain by Bogotá bag was used in 7% of the cases. The associated mortality was 16%. Conclusions: Main causes of secondary peritonitis were the appendix, follow by postoperative peritonitis. The preoperative diagnosis accuracy was 27%. The main complications found were suture failure, follow by intra-abdominal collections.
Keywords : Secondary peritonitis; Causes of peritonitis; Mortality.