A CLINICAL STUDY OF PERFORATIVE PERITONITIS PRESENTING WITH LEUKOCYTOPENIA PREOPREATIVELY

Abstract

In 170 cases of perforative peritonitis surgically treated at the institution during the past one decade, 24 cases were preoperatively associated with leukocytopenia of less than 5, 000/mm³. This decrease in white blood cell count was frequently found in aged patients or those with perforation of the large intestine. In these patients decreased white blood cell count increased soon after operation.
The mortality of leukocytopenia-associated patients was 12.5% without significant difference from that of no-leukocytopenia patients. However, in 11 patients concomitantly associating with hypotension on admission, the mortality was 27.3% versus null in 13 without hypotension. In the treatment operative procedure with less surgical invasion was selected, and postoperatively gamma-globulin preparations, plasma multi-enzyme inhibitors, H2-blockers were combinedly used. Leukocytopenia is reportedly a severe condition but appropriate treatment can save a life of such a fetal patient.