Complications of Laparostomy in Diffuse Peritonitis

The author reports that in Petrivalskis' clinic in the treatment of diffuse perforative peritonitis drainage is not used if the infectious focus is removed; abscesses are drained; antiseptics are also not used due to their harmful effect on the vital properties of the peritoneal endothelium, but it is recommended to infuse 50-100 cc into the abdominal cavity. 3% solution of hydrogenii superoxydati, and the resulting foam mechanically cleans the abdominal cavity, and the released oxygen produces oxidation of toxins.

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THE TREATMENT OF ACUTE DIFFUSE PERITONITIS

Southern Medical Journal ◽

10.1097/00007611-191810000-00009 ◽

1918 ◽

Vol 11 (10) ◽

pp. 686-687

Author(s):

H. A. Gamble

Keyword(s):

Diffuse Peritonitis

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The first experience of stapled intestinal anastomoses application in children in Ukraine

Paediatric Surgery Ukraine ◽

10.15574/ps.2020.68.15 ◽

2020 ◽

pp. 15-20

Author(s):

O. Sliepov ◽

◽

M. Migur ◽

O. Ponomarenko ◽

O. Gladyshko ◽

...

Keyword(s):

Body Weight ◽

Necrotizing Enterocolitis ◽

Postoperative Period ◽

Abdominal Cavity ◽

Operation Time ◽

Developed Countries ◽

Premature Baby ◽

Diffuse Peritonitis ◽

Level Of Evidence ◽

Intestinal Anastomoses

Introduction. Conducting reconstructive surgery in children, especially those with low body weight, associated with an increase in the operation time and a worsening of the postoperative period. Therefore, to reduce the operation time, surgical clinics in developed countries of the world use linear staplers for anastomoses in children, especially young children. Case report. A premature newborn, with a birth weight of 1420 g, was diagnosed with necrotizing enterocolitis, with ileal perforation and diffuse peritonitis. According to vital indications, the operation was performed: laparotomy, revision of the abdominal cavity, Mikulich enterostomy. After complete stabilization of the general condition of the child, upon reaching 2550 g of body weight, at the age of 2 months, enterostomy closure was performed with the imposition of a stapled side-to-side functional end-to-end ileoileostomy. In 14 days after the operation, the child achieved full enteral autonomy. There were no postoperative surgical complications. In the late postoperative period, the child gains weight well, grows and develops according to age. Conclusion. The use of linear staplers in time of enteroanastomoses creation can significantly reduce operation time in children, in particular, premature babies with low body weight. Level of evidence. Level V. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of an participating institution.The informed consent of the child’s parents was obtained from the studies. No conflict of interest was declared by the authors. Key words: linear staplers, enteroanastomosis, necrotizing enterocolitis, perforation of the small intestine, newborn premature baby.

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Intra-abdominal pressure monitoring in postoperative period in patients with diffuse peritonitis

Kazan medical journal ◽

10.17750/kmj2015-214 ◽

2015 ◽

Vol 96 (2) ◽

pp. 214-219 ◽

Cited By ~ 1

Author(s):

E K Salakhov ◽

K K Salakhov

Keyword(s):

Organ Failure ◽

Organ Dysfunction ◽

Dynamic Assessment ◽

Clinical Manifestations ◽

Multiple Organ ◽

Abdominal Pressure ◽

Diffuse Peritonitis ◽

Pressure Monitoring ◽

Systemic Complications ◽

Functional Changes

Epidemiology, etiology, pathologic and morphologic changes associated with increased intra-abdominal pressure are described. The most common ways of its measuring and monitoring are presented. Intra-abdominal pressure is increased by more than 15 mm Hg in patients with diffuse peritonitis. Increased intra-abdominal pressure is associated with the disease severity: the higher the intra-abdominal pressure, the more severe is the disease. If intra-abdominal pressure is increased over 20 mm Hg, treatment strategy depends on the signs of organ failure. In the absence of organ failure, intra-abdominal pressure should be monitored every 4 hours as long as the patient is in critical condition. Intra-abdominal pressure monitoring in case of peritonitis must be attributed to the mandatory manipulation, as pressure changes precede the clinical manifestations of intra-abdominal complications. Measurement of intra-abdominal pressure allows to detect the early signs of multiple organ failure, which is essential for the correction of systemic complications in pancreatogenic peritonitis. In this case, monitoring of intra-abdominal pressure in diffuse postoperative peritonitis should be considered only as a screening test for assessing of the organ dysfunction severity, as the development of multiple organ dysfunction syndrome involves complex pathophysiological mechanisms. Predictions that are more accurate can be made using such integrated indicators as APACHE II (Acute Physiology And Chronic Health Evaluation scale, which is used for assessing various acute and chronic diseases), SAPS (Simplified Acute Physiology Score - a simplified scale for acute functional changes assessment), SOFA (Sepsis-related Organ Failure Assessments Score - scale for dynamic assessment of organ failure in sepsis), MPI (Mannheim Peritonitis Index) scales.

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MICROBIOLOGICAL PECULIARITIES OF THE CLINICAL COURSE OF ACUTE DIFFUSE PERITONITIS AGAINST THE GROUND OF COLON CANCER

Clinical anatomy and operative surgery ◽

10.24061/1727-0847.14.4.2015.4 ◽

2015 ◽

Vol 14 (4) ◽

pp. 21-25

Author(s):

I. Ya. Hushul

Keyword(s):

Colon Cancer ◽

Clinical Course ◽

Diffuse Peritonitis

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The Management of Acute Colonic Diverticulitis in the COVID-19 Era: A Scoping Review

Medicina ◽

10.3390/medicina57101127 ◽

2021 ◽

Vol 57 (10) ◽

pp. 1127

Author(s):

Roberto Cirocchi ◽

Riccardo Nascimbeni ◽

Gloria Burini ◽

Carlo Boselli ◽

Francesco Barberini ◽

...

Keyword(s):

Decision Making ◽

Scoping Review ◽

Percutaneous Drainage ◽

Acute Diverticulitis ◽

Treatment Strategies ◽

Complicated Diverticulitis ◽

Diffuse Peritonitis ◽

Open Approach ◽

Surgical Decision ◽

Surgical Decision Making

Background and Objective: During the COVID-19 pandemic, health systems worldwide made major changes to their organization, delaying diagnosis and treatment across a broad spectrum of pathologies. Concerning surgery, there was an evident reduction in all elective and emergency activities, particularly for benign pathologies such as acute diverticulitis, for which we have identified a reduction in emergency room presentation with mild forms and an increase with more severe forms. The aim of our review was to discover new data on emergency presentation for patients with acute diverticulitis during the Covid-19 pandemic and their current management, and to define a better methodology for surgical decision-making. Method: We conducted a scoping review on 25 trials, analyzing five points: reduced hospital access for patients with diverticulitis, the preferred treatment for non-complicated diverticulitis, the role of CT scanning in primary evaluation and percutaneous drainage as a treatment, and changes in surgical decision-making and preferred treatment strategies for complicated diverticulitis. Results: We found a decrease in emergency access for patients with diverticular disease, with an increased incidence of complicated diverticulitis. The preferred treatment was conservative for non-complicated forms and in patients with COVID-related pneumonia, percutaneous drainage for abscess, or with surgery delayed or reserved for diffuse peritonitis or sepsis. Conclusion: During the COVID-19 pandemic we observed an increased number of complicated forms of diverticulitis, while the total number decreased, possibly due to delay in hospital or ambulatory presentation because of the fear of contracting COVID-19. We observed a greater tendency to treat these more severe forms by conservative means or drainage. When surgery was necessary, there was a preference for an open approach or a delayed operation.

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