ArticleEuropean journal of medical research2009
Diffuse postoperative peritonitis -- value of diagnostic parameters and impact of early indication for relaparotomy.
Article in European journal of medical research, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Vacuum-assisted closure or primary closure with relaparotomy on-demand in patients with secondary peritonitis: a systematic review and meta-analysis.World journal of emergency surgery : WJES · 2025Pooled it
- Article
- Article
- The mesenteric entry site as a potential weak point in gastrointestinal anastomoses - findings from an ex-vivo biomechanical analysis.Langenbeck's archives of surgery · 2024Article
- Associated Factors of Leaked Repair Following Omentopexy for Perforated Peptic Ulcer Disease; a Cross-sectional Study.Archives of academic emergency medicine · 2024Article
- Vacuum-assisted closure versus on-demand relaparotomy in patients with secondary peritonitis-the VACOR trial: protocol for a randomised controlled trial.World journal of emergency surgery : WJES · 2022Article
- Diagnostic Challenges in Sepsis.Current infectious disease reports · 2021Review
- Loose PEG Tube Leading to Peristomal Leakage and Peritonitis, a Case Report.Journal of education & teaching in emergency medicine · 2020Article
- Calculated parenteral initial treatment of bacterial infections: Intra-abdominal infections.GMS infectious diseases · 2020Article
- Predictors of 30-Day In-Hospital Mortality in Patients Undergoing Urgent Abdominal Surgery Due to Acute Peritonitis Complicated with Sepsis.Medical science monitor : international medical journal of experimental and clinical research · 2019Article
- Intra-abdominal sepsis: new definitions and current clinical standards.Langenbeck's archives of surgery · 2019Review
- Damage control surgery in perforated diverticulitis: ongoing peritonitis at second surgery predicts a worse outcome.International journal of colorectal disease · 2018Article
- Intraperitoneal lactate/pyruvate ratio and the level of glucose and glycerol concentration differ between patients surgically treated for upper and lower perforations of the gastrointestinal tract: a pilot study.BMC research notes · 2017Observational
- Risk factors for mortality in postoperative peritonitis in critically ill patients.World journal of critical care medicine · 2017Article
- Association between source control and mortality in 258 patients with intra-abdominal candidiasis: a retrospective multi-centric analysis comparing intensive care versus surgical wards in Spain.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2017Article
- Current understanding in source control management in septic shock patients: a review.Annals of translational medicine · 2016Review
- The Role of Planned and On-Demand Relaparotomy in the Developing World.World journal of surgery · 2016Article
- [Antibiotic therapy of intra-abdominal infections in the era of multiresistance].Der Chirurg; Zeitschrift fur alle Gebiete der operativen Medizen · 2016Review
- The challenge of post-operative peritonitis after gastrointestinal surgery.Updates in surgery · 2015Review
- Surgical risk model for acute diffuse peritonitis based on a Japanese nationwide database: an initial report on the surgical and 30-day mortality.Surgery today · 2015Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveCurrent criteria for performing relaparotomy for suspected peritonitis are non explicit and based on non-quantitative, subjective arguments or hospital practice. The aim of this study was to determine the value of routinely used clinical and diagnostic parameters in early detection of postoperative, diffuse peritonitis (PP). Furthermore, the prognosis and outcome after early indication for relaparotomy in patients with PP compared to community-aquired peritonitis (CAP) was evaluated.
methodsBetween 1999 and 2008, a total of 251 patients with diffuse secondary peritonitis either postoperative (PP) or community acquired (CAP) were analyzed retrospectively. PP (n = 114) and CAP (n = 137) were compared regarding physical examination, MPI-Score, APACHE II-Score, evidence of organ failure, laboratory parameters, diagnostic instruments and clinical course. The treatment regimen comprised surgical source control (with/without programmed lavage), abdominal closure and relaparotomy on demand, broad spectrum antibiotic therapy and intensive care support.
resultsThe APACHE II-Score (20 CAP vs. 22 PP, p = 0.012), MPI-Score (27 CAP vs. 30 PP, p = 0.001) and the number of lavages differed significantly. Positive phyiscal testing and signs of sepsis (abdominal pain (81.6% PP vs. CAP 97.1%, p = 0.03), rebound tenderness (21.9% vs. 35.8%, p = 0.02), fever (35.1% vs. 51.8%, p = 0.03)) occurred significantly less often in the PP patients than in the CAP group. Conventional radiography (66.2%) and ultrasonography (44.3%) had a lower diagnostic sensitivity than did abdominal CT-scan (97.2%). Mortality was higher in the PP group but did not differ significantly between the two groups (47.4% PP vs. 35.8% CAP, p = 0.06).
conclusionThe value of physical tests and laboratory parameters in diagnosing abdominal sepsis is limited. CT-scanning revealed the highest diagnostic accuracy. A treatment regimen of early relaprotomy appears to be the most reasonable strategy for as early discovery of postoperative peritonitis as possible.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.