Journal of ISSN: 2373-6437JACCOA

Anesthesia & Critical Care: Open Access
Commentary
Volume 6 Issue 4 - 2016
Reasons for the Resumption of a Peritonity for the Resuscitation of Surgical Emergencie
A Jerrari*, A Nsiri, MA Bouhouri and R Harrar
Surgical emergency Resuscitation Service, CHU Ibn Rochd, Morroco
Received: November 30, 2016 | Published: December 16, 2016
*Corresponding author: Jerrari Ayoub, Surgical emergency Resuscitation Service, CHU Ibn Rochd, Casablanca, Morroco, Email:
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.

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