Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0031154 (peritonitis)
 15,372 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We studied the clinical course of 506 children consecutively admitted with appendicitis at The Hospital for Sick Children from 1985 to 1989. One hundred eighty-one children (35%), ranging in age from 1 to 17 years, presented with perforation verified by histological examination. Ninety-six of them (53%) had generalized peritonitis, 47 (26%) had localized peritonitis, and 38 (21%) had abscess formation. Usually, triple antibiotics were begun preoperatively if perforation was suspected; otherwise, cefoxitin was started. Triple antibiotics were used postoperatively for 5 to 7 days in almost all children in the perforated group. Neither abdominal nor subcutaneous drainage was routinely used even in cases of intraabdominal abscess. The skin was closed primarily with steri-strips (63%), staples (20%), subcutaneous Dexon (11%), or silk (4%). Postoperative wound infection arose in 20 children (11%). Wound infections were noted from 1 to 14 days postoperatively (mean, 5.9 days). Whereas 9 of these were treated with local therapy only, 11 delayed the child's discharge or necessitated readmission. No patient suffered major complications from wound infection in that there were no cases of necrotizing fasciitis, reoperation for debridement, sepsis, or death. The intraabdominal abscess rate in this group of 181 children was 6% (n = 11). The low rate of infective complications fully justifies the policy of primary closure in contaminated wounds. This policy eliminates the necessity for painful and time-consuming dressing changes, shortens hospitalization, and obviates the trauma of delayed suturing of wounds in children.
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PMID:Primary closure of contaminated wounds in perforated appendicitis. 176 7

Open management of the peritoneal cavity with mesh insert in severe peritonitis has been the subject of favorable clinical reports. The present study was undertaken to develop an animal model suitable for investigation of this technique. Peritonitis was induced in anesthetized rats using the technique of cecal puncture following nonobstructing cecal ligation. A pilot study with this technique did not result in either intestinal distention or edema. Therefore, distal ileal ligation was added to duplicate the clinical findings associated with diffuse peritonitis. Twenty animals treated in this manner underwent standard abdominal wall closure and were simply observed for 96 hours. This produced a 15 per cent mortality at 24 hours, 65 per cent at 48 hours, 70 per cent at 72 hours, and 80 per cent at 96 hours. A second group underwent sham laparotomy only (n = 5) with a resultant 100 per cent survival. Based on these preliminary findings, two study groups were defined. Animals in both groups had cecal ligation and puncture and ileal ligation performed. Group I (n = 22) animals underwent re-laparotomy 24 hours later with primary fascial closure, while group II (n = 23) animals underwent re-laparotomy at 24 hours with placement of a standardized Dexon mesh insert covered by a superficial polyethylene film to prevent fluid loss. No animals received antibiotics. Cumulative mortalities in group I were 77, 90, 90, and 90 per cent at 24, 48, 72, and 96 hours after reoperation. In group II mortalities were found to be 48, 57, 61, and 70 per cent at 24, 48, 72, and 96 hours.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Open peritoneal management in murine peritonitis. 216 38

Polyglycolic acid (PGA) meshes have successfully been used in the treatment of injured parenchymatous organs. In our study we investigated the value of PGA meshes for reinforcement of colon anastomoses in a rat model. In 75 Wistar rats the transverse colon was transected and reanastomosed in a single-layer technique. The anastomoses in half of the animals were performed with 6 stitches. In the other animals the anastomoses were performed with 4 stitches only and were therefore supposed to leak. In half of the animals of each group a PGA mesh was used to cover the anastomoses. Animals of each group were sacrificed after 2, 4, 8, 30 and 60 days. The bursting strength of the anastomoses was determined and the anastomosed region was examined histologically. The results demonstrate that regardless of how the anastomosis was applied motility disorders, delayed healing or leakage followed by peritonitis only occurred in animals in which a PGA mesh was used. The determination of the bursting strength also showed a marked decrease in all rats in which the anastomosis was reinforced with a PGA mesh. We therefore conclude that PGA mesh application in colon anastomoses results in impaired healing, which is probably due to reduced peritoneal or omental contact.
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PMID:Reinforcement of colon anastomoses with polyglycolic acid mesh: an experimental study. 217 59

A rare case of Richter's hernia after laparoscopy, the 2nd such hernia reported among a total of 4 cases of small bowel hernia, is presented. This patient was a 32-year old woman who had Hulka clip sterilization without any difficulties, using a 10 mm trocar and a Wolff laparoscope, with 3 liter carbon dioxide for induction of pneumoperitoneum. Her symptoms were only severe pain and vomiting starting on the 5th postoperative day, and a hematoma-like swelling. Since her pain was so intense, the area was explored under general anesthesia the same day. A plum-sized, strangulated loop of the jejunum was apparent, with serous fluid but no blood, incarcerated between the skin and the abdominal muscles. A small serosal laceration in the bowel was corrected with 2 interrupted Dexon sutures. Symptoms of hernia have occurred 3-15 days after laparoscopy in previously reported cases. It is fortunate that this patient was not treated as though she had a hematoma, since serious perforation of the bowel and peritonitis would have resulted. It is important to insure that all gas has flowed out of the abdomen before removing the laparoscope or the trocar sheath, and advisable to shake the abdomen wall carefully while removing the instruments, to prevent this complication.
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PMID:Incarcerated Richter's hernia after laparoscopy: a case report. 296 30