Primary small bowel anastomosis in generalised peritonitis.

OBJECTIVE

To find out if primary small bowel anastomosis of the bowel is safe in patients with generalised peritonitis who are treated by planned relaparotomies.

DESIGN

Retrospective study.

SETTING

University hospital, The Netherlands.

SUBJECTS

10 Patients with generalised purulent peritonitis caused by perforation of the bowel.

INTERVENTIONS

Resection or wedge resection of the bowel and primary intestinal anastomosis followed by planned relaparotomies every 24-48 hours.

MAIN OUTCOME MEASURES

Mortality and morbidity with special reference to anastomotic leaks.

RESULTS

Two patients died. Four of 20 wedge excisions in one patient leaked. All 19 end-to-end anastomoses in 10 patients healed without complications. Two patients developed small bowel fistulas which were not related to the anastomoses.

CONCLUSION

Primary end-to-end anastomosis of the small bowel followed by planned relaparotomies seems a safe alternative to the creation of an enterostomy in patients with generalised purulent peritonitis and perforation of the bowel.