Open management of the abdomen and planned reoperations in severe bacterial peritonitis.
OBJECTIVE
To assess the results of open management of the abdomen and planned re-operations in severe bacterial peritonitis after perforation or anastomotic disruption of the digestive tract.


METHODS
Retrospective study.


METHODS
University Hospital, The Netherlands.


METHODS
67 consecutive patients.


METHODS
Open management of the abdomen and planned reoperations.


METHODS
Hospital morbidity and mortality, long-term follow-up.


RESULTS
38 patients developed multiple organ failure (MOF), but 29 needed only ventilatory and inotropic support. The mean number of re-operations was nine. 16 patients developed severe bleeding and 16 fistulas. In-hospital mortality was 42% (n = 28). Long-term morbidity, particularly the number of abdominal wall defects (n = 10), was considerable.


CONCLUSIONS
Despite open management of the abdomen and planned re-operations, mortality of severe bacterial peritonitis still continues to be too high, and both short and long-term morbidity are appreciable. The value of open management of the abdomen and planned re-operations rests only on the clinical observation that other conventional surgical treatments of severe bacterial peritonitis often fail.
Bosscha
K
K
Department of Surgery, University Hospital Utrecht, The Netherlands.
Hulstaert
P F
PF
Visser
M R
MR
van Vroonhoven
T J
TJ
van der Werken
C
C
D000005:Abdomen / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001424:Bacterial Infections; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009102:Multiple Organ Failure / Q000453:epidemiology / Q000209:etiology; D010538:Peritonitis / Q000382:microbiology* / Q000401:mortality / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013514:Surgical Procedures, Operative; D013997:Time Factors; D016896:Treatment Outcome