[Etiology and therapeutic aspects of generalized acute peritonitis of digestive origin. A survey of 207 cases operated in five years].
Generalized acute peritonitis is defined as a brutal and diffuse peritoneum inflammatory.


OBJECTIVE
To assess the organic aspects of acute peritonitis of digestive origin and to evaluate the results of their surgical treatment.


METHODS
Between January 1997 and December 2001, 221 patients were operated for generalized acute peritonitis. Among them, 207 patients (93.6%) had a digestive aetiology and were included in this study. They were 188 men (91%) and 19 women (9%). The average age of patients was 31.1 +/- 10.1 years old with extremes of 16 and 74 years. The organic (aetiologies) and therapeutic aspects as well as the remote follow-up were studied.


RESULTS
The following aetiologies were found: perforation of gastro-duodenal ulcer, 109 cases (52.7%), complicated appendicitis, 76 cases (36.7%), ileal perforation, 13 cases (6.3%), colic perforation, 5 cases (2.4%), jejunal perforation, 1 case (0.5%), rupture of liver abscess, 1 case (0.5%) and pyo-cholecyst, 2 cases (0.9%). Complications had occurred among 65 patients i.e. 31.4% of the cases and were distributed as follows: local wound abscess, 42 cases (20.3%); evisceration, 10 cases (4.8%); post-operative peritonitis, 6 cases (2.9%); digestive fistula, 4 cases (2%) and resumption of ileostomy, 3 cases (1.4%). Mortality concerned 19 patients and the rate was 9.1%. Aetiology of death was septic shock or multiorgan failure in most of cases. The average time in which the continuity of the digestive tract was restored after stoma was 36.3 +/- 10.7 days. The late complications were: incisional hernia in 7 cases (3.5%), small bowel obstruction in 3 cases (1.5%) and pylorus stenosis in 1 case (0.5%).


CONCLUSIONS
The perforations of gastro-duodenal ulcers, in first, followed complicated appendicitis are the most frequent aetiology. Mortality and morbidity, especially in parietal peritonitis, are not negligible.
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D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D004066:Digestive System Diseases / Q000150:complications*; D004322:Drainage / Q000379:methods; D005260:Female; D006306:Health Surveys; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008302:Mali / Q000453:epidemiology; D008499:Medical Records; D008875:Middle Aged; D010538:Peritonitis / Q000209:etiology* / Q000401:mortality / Q000601:surgery* / Q000628:therapy; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome