Acute peritonitis in childhood

Abstract

It would appear from this review that: 1. 1. Pneumococcic and non-pneumococcic peritonitis in children is rarely primary, but usually complicates infections of the upper respiratory tract, whereas in the acute suppurative peritonitis due to a ruptured viscus (appendicitis) a primary focus of infection is seldom found. 2. 2. The role of the kidney in the extension of the organisms from its source to the peritoneum deserves thorough study as an etiologic factor. 3. 3. Pneumonia in children is rarely complicated by pneumococcic peritonitis. 4. 4. Clinically, cases of pneumococcic, non-pneumococcic and severe cases of acute diffuse secondary suppurative peritonitis cannot be differentiated. However, these entities should be differentiated by symptomatology from acute suppurative secondary peritonitis. 5. 5. Outside of careful early peritoneal puncture for bacteriologica study, no laboratory procedure was of diagnostic or prognostic value. 6. 6. Non-pneumococcic peritonitis in childhood offers the worst prognosis (15 per cent recoveries), pneumococcic next (30 per cent) and acute suppurative peritonitis a good prognosis (70 per cent recoveries). 7. 7. Early laparotomy with drainage within three days of the onset or later when there is definite abdominal localization offers the best prognosis. 8. 8. Blood transfusions or other therapeutic procedures were of no avail and the early use of drastic cathartics, enemata or disturbing therapeutic measures are distinctly contraindicated.