medigraphic.com
ISSN 1561-2945 (Print)

2019, Number 2

<< Back Next >>

Revista Cubana de Cirugía 2019; 58 (2)

Morbidity and mortality due to secondary peritonitis in the surgery service

Mesa IO, Ferrer RH, Mora BR, Matos RYA, Travieso PG

Language: Spanish
References: 16
Page: 1-13
PDF size: 335.77 Kb.


ABSTRACT

Introduction: Secondary peritonitis is caused by contamination of the peritoneal cavity. It continues to be a serious disease with high morbidity and mortality.
Objective: To determine morbidity and mortality due to secondary peritonitis in the Surgery Department of Comandante Pinares General Teaching Hospital.
Method: A descriptive, prospective and observational study was carried out with patients admitted to the general surgery service with secondary peritonitis between October 2015 and March 2018. From a population of 40 patients, a sample of 36 patients who met the inclusion criteria was chosen. Descriptive statistical methods and calculations with percentage values were used.
Results: The highest incidence corresponds to the male sex 19 (52.8%), with a predominance of the group between 50 and 69 years old (38.9%); smoking is the most frequent comorbidity, accounting for 52.8% of patients; the most represented complications were the perforation syndrome, which caused 22.2% of the peritonitis, followed by intestinal occlusion (16.7%), paralytic ileus (25%) and the electrolyte and acid-base imbalance (19.4 %); 52.8% of patients underwent laparotomy with large-scale lavage of the abdominal cavity, the rest received scheduled laparotomy (33.3%) or on demand (13.9%); 77.8% of patients were discharged alive, while 22.2% (8 patients) died.
Conclusions: Morbidity and mortality in patients with secondary peritonitis continues to be a health problem that requires timely diagnosis and intervention.


REFERENCES

  1. Cheadle WG, Spain DA. The continuing challenge of intra-abdominal infection. Am J Surg. 2013;186(5A):15S-22S; discussion 31S-34S.

  2. Mosdell DM, Morris DM, Voltura A, Pitcher DE, Twiest MW, Milne RL, et al. Antibiotic treatment for surgical peritonitis. Ann Surg. 1991;214(5):543-9.

  3. Barie PS, Hydo LJ, Eachempati SR. Longitudinal outcomes of intra-abdominal infection complicated by critical illness. Surg Infect (Larchmt). 2014;5(4):365-73.

  4. Kim PW, Perl TM, Keelaghan EF, Langenberg P, Perencevich EN, Harris AD, et al. Risk of mortality with a bloodstream infection is higher in the less severely ill at admission. Am J Respir Crit Care Med. 2005 [acceso 3/6/2018];171(6):616-20. Disponible en: https://www.atsjournals.org/doi/full/10.1164/rccm.200407-916OC

  5. Montravers P, Lepape A, Dubreuil L, Gauzit R, Pean Y, Benchimol D, et al. Clinical and microbiological profiles of community-acquired and nosocomial intra-abdominal infections: results of the French prospective, observational EBIIA study. J Antimicrob Chemother. 2009;63(4):785-94.

  6. Weigelt JA. Empiric treatment options in the management of complicated intra-abdominal infections. Cleve Clin J Med. 2017;74(Suppl 4):S29-37.

  7. Suárez M. Infecciones intraabdominales: Peritonitis y abscesos. MEDICRIT. Revista de Medicina Interna y Medicina Crítica. 2004 ago [acceso 16/9/2013];1(4). Disponible en: http://www.google.com.ec/url?sa=t&rct=j&q=&esrc=s&source=web&cd=1&ved=0CCkQFjAA&url=http%3A%2F%2Fwww.medicrit.com%2Frev%2Fv1n4%2F14146.pdf&ei=B-FvUoyGGYyDkQeT_IGYAg&usg=AFQjCNEGyN-iXl7bp8nq3O5c5ksiR8ympQ&bvm=bv.55123115,d.eW0

  8. Castañeda Carranza CD, Tepeu Tajiboy FM. Valor pronóstico de mortalidad del índice de Mannheim en pacientes con peritonitis secundaria. Hospital General San Juan de Dios, mayo-junio de 2015. [Tesis Especialidad en Cirugía General]. Universidad de San Carlos de Guatemala. Facultad de Ciencias Médicas.

  9. Núñez Bustos CM. Utilidad del índice de peritonitis de Mannheim en pacientes con peritonitis secundaria atendidos en el Hospital Escuela Dr. Roberto Calderón Gutiérrez en el período de enero a marzo de 2014. [Tesis Especialidad en Cirugía General] Managua: Universidad Nacional Autónoma de Nicaragua, Facultad de Ciencias Médicas. 2015. [acceso: 11/02/18]. Disponible en: http://www.minsa.gob.ni/bns/monografias/Full_text/cirugia_general/utilidad_indice_peritonitis.PDF.

  10. Wittmann DH, Schein M, Condon RE. Management of secondary peritonitis. Ann Surg. 2016;224(1):10-8.

  11. Langell JT, Mulvihill SJ. Gastrointestinal perforation and the acute abdomen. Med Clin North Am. 2017;92:599-625.

  12. Guirao X. Recommendations in the empiric anti-infective agents of intra-abdominal infection. Cir Esp. 2010;87(2):63-81.

  13. Díaz de León M, Moreno SA, González Díaz DJ, Briones GJ. Severe sepsis as a cause of acute renal failure. Nefrologia. 2016;26:439-44.

  14. Schouten M, van 't Veer C, van der Poll T, Levi M. Effect of the factor V Leiden mutation on the incidence and outcome of severe infection and sepsis. Neth J Med. 2012;70:306-10.

  15. Ordóñez Delgado CA, Arias Gómez Rh, Pineda Alzate JA, Aristizábal Vásquez G, Toro Yepes LE, Franco Gutiérrez JE, et al. Mortalidad y morbilidad de la peritonitis secundaria con relaparotomía planeada. Revista Colombiana de Cirugía. 2006;21(2):13-9.

  16. Morales Díaz IA, Pérez Migueles L, Pérez Jomarrón E. Peritonitis bacteriana difusa. Análisis de 4 años (1995-1998). Rev Cubana Cir. 2000;39(2):160-6.




2020     |     www.medigraphic.com