The significance of the rate of progression of purulent peritonitis in patients with acute surgical pathology

In recent years, the periodic literature suggests dividing peritonitis based on the speed of its development into primary peritonitis (PP) and secondary peritonitis (SP). The significance of the speed of development of purulent peritonitis has not been studied yet.

The aim of the study was to assess the impact of the rates of peritonitis development on treatment outcomes in patients with purulent peritonitis.

Materials and Methods: A total of 113 patients with purulent peritonitis were analyzed. The incidence of peritonitis with varying rates of development, its etiological structure, and treatment outcomes were studied.

Results: The PP group included 56 (49.6%) patients, while the SP group included 57 (50.4%) patients. In the PP group, 64.3% of cases had pathology of the upper gastrointestinal tract as the source of peritonitis. In 35.7% of cases, the source of abdominal cavity contamination was the lower gastrointestinal tract and structures localized outside the digestive tract. In the SP group, 70.1% of patients had the lower gastrointestinal tract as the source of peritonitis. In 29.9% of cases, the source was identified as the upper gastrointestinal tract and structures localized outside the digestive tract. The postoperative mortality rate in the PP group reached 62.5%, which correlated with a frequency of somatic complications of 69.4%. Mortality in the SP group was 35.1% (p < 0.05), with somatic complications recorded in 40.3% of cases (p < 0.05).

Conclusion: The rates of development of purulent peritonitis have a significant impact on treatment outcomes for patients.

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