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.