Causes of postoperative peritonitis occurrence in the injured persons with gun-shot abdominal wounds

In 43 (39.1%) injured persons with gun-shot abdominal wounding postoperative complications have occurred, demanding reoperations. The most frequent of them were postoperative peritonitis, purulent complications, recurrent hemorrhage, early adhesive ileus. Inadequate abdominal cavity sanation in gun-shot wounding, perforation of deserosated places of intestinal wall, an acute ulcers of hollow organs, lost and not revealed foreign bodies in abdominal cavity were the causes of the progressing postoperative peritonitis occurrence. Absence of some signs, characteristic for postoperative peritonitis, made the diagnosis difficult, that is why in majority of observations the relaparotomy conduction was very delayed. Relaparotomy was conducted on the first-second day, as a rule, for insufficiently sanated abdominal cavity and on the 5-7th day--for perforation of the compound places in hollow organs. Antibacterial therapy was conducted for progressing peritonitis, duration of which depended on dynamics of the peritonitis course. The complications rate reduction was promoted by conduction of an active postoperative sanation of abdominal cavity and potent antibacterial therapy. One patient died because of the wounding severity.