[Peritonitis of large-bowel origin--complicated colorectal carcinoma].

A total of 803 patients presenting colorectal carcinoma are operated on over a 14-year period (1979 through 1992). In 272 cases (33.8 per cent) the disease runs a complicated clinical course. Perforative peritonitis is recorded in 29 cases-10.6 per cent of the total number of patients with complicated course, and 3.6 per cent of the total number subjected to operation. Ileus peritonitis free of perforation is discovered in twenty-seven cases-9.5 per cent of 272, and 3.23 per cent of the total number-803. The microbiological study of abdominal cavity exudate from the patients with ileus peritonitis points to predomination of anaerobic micro-organisms, having an essential practical bearing on performing adequate perioperative and postoperative antibiotic treatment, and peritoneal cavity lavage during the operation. Radical two-staged operations with removal of the perforated neoplastic process in the first stage and preternatural anus formation are the method of choice. Palliative operations leaving the perforated carcinoma within the abdominal cavity account for 100 per cent lethality. A radical one-staged operation is indicated only in the event of localized peritonitis, young patients, preserved good general condition, usually following right hemicolectomy.