[Peritonitis secondary to gastrointestinal perforations].

BACKGROUND

The study was designed to check the etiopathogenesis of gastrointestinal perforations and to indicate possible factors determining better results in terms of mortality and morbidity.

METHODS

A retrospective study was carried out on 128 patients operated during the last 10 years for gastrointestinal perforation at our Department of Emergency Surgery, where about 600 abdominal surgical operations are performed every year. In this study patients with perforated acute appendicitis and patients with postoperative anastomotic leakage were excluded. Surgical techniques were essentially of three types: drainage of the collection, suture of the perforation (with or without proximal stoma), resection with or without immediate anastomosis.

RESULTS

89% of the patients had an uneventful recovery, 9 patients (7%) died, and 5 (4%) had local infective complications cured by conservative measures (antibiotics, percutaneous drainage).

CONCLUSIONS

Better results have been observed during the last years in patients operated for gastrointestinal perforation probably because of the more frequent use of sophisticated diagnostic examinations (especially ultrasound and CT scan) and also because of better timing and technique of surgery (more frequent use of Hartmann procedure as well as mechanical staplers).