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Commentary Volume 6 Issue 4
Reasons for the Resumption of a Peritonity for the Resuscitation of Surgical Emergencie
A Jerrari,
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A Nsiri, MA Bouhouri, R Harrar
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Surgical emergency Resuscitation Service, CHU Ibn Rochd, Morroco
Correspondence: Jerrari Ayoub, Surgical emergency Resuscitation Service, CHU Ibn Rochd, Casablanca, Morroco
Received: November 30, 2016 | Published: December 16, 2016
Citation: Jerrari A, Nsiri A, Bouhouri MA, Harrar R (2016) Reasons for the Resumption of a Peritonity for the Resuscitation of Surgical Emergencie. J Anesth Crit Care Open Access 6(4): 00234. DOI: 10.15406/jaccoa.2016.06.00234
Commentary
The resumption of peritonitis is a serious complication of abdominal and pelvic surgery. It’s a medical-surgical emergency whose prognosis depends on the speed and quality of care, the underlying terrain and etiology.
We conducted a descriptive analytic retrospective study over a period of 5 years (January 2011 to December 2015) 60 cases of peritonitis hospitalized in resuscitation P33.The age of our patients Middle was 44.36 years with a sex ratio of 1,5(36H/24F). The most frequent risk factors were: factors relating to the ground, and factors related to the initial peritonitis. Clinical signs were dominated by fever (75%), abdominal pain (52%). The period of the average recovery was 8.2 days. The decision of the surgical revision was based on a body of clinical, biological and radiological. 40 patients in our series, 67% of cases were taken on clinical and biological criteria while 15 patients 25% were taken on radiological criteria. In 8% of the remaining cases, the potential severity of the clinical and biological state in association with an inconclusive ultrasound, led to reoperation.
The therapeutic treatment was based on a perioperative resuscitation, treatment of organ failure, empirical antibiotic therapy and by midline laparotomy surgery. Bacteriological samples performed intraoperatively allowed to have the following bacteriological profile: predominance of BGN (79%) dominated by E. coli (28%) followed by Klebsiella pneumoniae (21%), Acinetobacter and Enterococcus baumanii (12%). The multimicrobien character was found in 55%. The E. coli-Klebsiella pneumoniae association was the most frequent (37%).
The anastomotic dehiscence was the direct cause of the most common surgical revision found intraoperative (62%). The average hospital stay was 8 days. The mortality rate was 61%. The main prognostic factors in our study emerged in the univariat analysis were: kidney failure, the number of organ failure, a TP <50% the needs of ventilation and the use of catecholamine’s.
Mortality is variable depending on the studies, between 25 and 60%. The diagnosis often difficult. Only effective and early therapeutic management reduces mortality remains high in recent years despite the various advances in the field of surgery and reanimation.
Acknowledgments
None.
Conflicts of interest
The authors declare there are no conflicts of interest.
Funding
None.
©2016 Jerrari, et al. This is an open access article distributed under the terms of the, which permits unrestricted use, distribution, and build upon your work non-commercially.