1986 Volume 47 Issue 5 Pages 581-587
Twenty-five cases of perforation of the intestinal tract, distal to the duodenum, are reported with the following findings:
1. The causes of the perforation were benign in 57% (4) of the cases of small bowel disease and in 72% (13) of the cases of large bowel disease.
2. The mean age at the time of perforation was 60.6 years and the perforation was accompanied by relatively few signs and symptoms.
3. Bacterial peritonitis was found in the early phase in all cases. Most patients had mixed infections (gram-negative bacilli and anaerobic bacilli).
4. In patients with leucopenia (WBC<5000), mortality from the perforation was very high (71.4%).
5. Endotoxin probably played a role in 62.5% of the deaths (5 cases) by inducing multiple organ failure or disseminated intravascular cogaulopathy.
In conclusion, general systematic care of the patient is as important as optimal operative judgment and selection of antibiotics.
