Carretier M, Coste G, Jardel P, Reynaud J, Montaz N, Barbier J
Sem Hop. 1984 Jan 19;60(2):113-8.
The authors analyze sixty-two cases of acute generalized peritonitis with a non-traumatic colonic etiology. They point out that the prognosis depends on three main factors: the age of the patient, the time spent in diagnosis and the therapeutic difficulties. They recommend a gastrographin colonic enema to obtain earlier diagnosis, in the absence of radiological evidence of pneumoperitoneum, in elderly patients presenting with abdominal signs. They also recommend multistage surgical management combining effective drainage of the abdominal cavity with resection of the perforated segment of the colon, whenever there is extensive damage to the colon, or in the presence of a tumor. In their view, conservative surgery should be confined to strictly selected cases not involving tissue resection. These indications are essential if a satisfactory result is to be achieved.
作者分析了62例非创伤性结肠病因引起的急性弥漫性腹膜炎病例。他们指出，预后取决于三个主要因素：患者年龄、诊断所花费的时间以及治疗难度。他们建议，对于出现腹部体征的老年患者，在没有气腹的放射学证据时，采用泛影葡胺结肠灌肠以获得早期诊断。他们还建议，只要结肠有广泛损伤或存在肿瘤，就采用多阶段手术治疗，将有效的腹腔引流与结肠穿孔段切除相结合。他们认为，保守手术应仅限于严格挑选的不涉及组织切除的病例。如果要取得满意的结果，这些指征至关重要。
