[The syndrome of the fifth day (author's transl)].

After operation of uncomplicated forms of appendicitis in children postoperative complications characterised by sudden vehement stomach-ache, quickly increasing tension of the abdominal wall, rise of temperature, pulse and white blood cells as well as vomitus, mostly on the fifth post-operative day could be observed. French authors call it "the syndrome of the fifth day". We observed this syndrome in 12 patients of 2.814 appendectomies in infancy. The treatment demands an immediate introduction of an intensive care by gastric suction intravenous fluid replacement and high doses of antibiotics. If these measures are not followed by an improvement within a few hours, a relaparotomy will be indicated. Then liquid pus is to be found in the abdomen and only a fibrin film in the primary operation field. In single cases we found a partial suture dehiscence. The aetiology of this complication has not been cleared yet.