HALF A CENTURY OF EXPERIENCE IN THE EVOLUTION OF APPROACHES TO THE TREATMENT OF PERITONITIS AND THE SPECIFICS OF THEIR CHANGES

Authors:

Abstract:

From 1975 to 2024, 1,352 patients with secondary postoperative peritonitis were operated at the Topchubashov Scientific Center of Surgery: 703 (52 %) had localized peritonitis, 446 (33 %) had diffuse peritonitis, and 203 (15 %) had generalized peritonitis. Microbiological studies were performed in 52 patients (25.6 % of the total number of cases) using samples taken from the parietal and visceral peritoneum and peritoneal exudate. With localized peritonitis, no more than two loops of the small intestine were affected. In diffuse cases, 40–70 % of the loops were affected, while with widespread peritonitis, more than 80 % of the serous surfaces were covered with purulent fibrinous deposits. Sanitation of the abdominal cavity led to the removal of microorganisms from the parietal peritoneum and exudate in 55 % of cases, but from the intestinal serosa – only in 11 %, which is five times less. Postoperative mortality was 0.7 % for localized peritonitis, 5.6 % for diffuse peritonitis, and 96 % for widespread peritonitis. The classification of the severity of peritonitis should include both the degree of purulent inflammation of the abdominal cavity and the proportion of affected loops of the small intestine. When more than 80 % of the loops are affected, the disease is practically incurable, and aggressive surgical approaches such as laparostomy with repeated relaparotomies are unjustified and ethically problematic.

Keywords:

peritonitis intestinal insufficiency treatment methods

References:

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Publication:

«World of Medicine and Biology» Vol. 22 No. 97 (2026), pp. 75-80
UDC 616.381-002; 617-089.84-089.16

DOI:

https://doi.org/10.26724/2079-8334-2026-3-97-75-80