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September 30, 1939

THE MANAGEMENT OF PATIENTS WITH DIFFUSE PERITONITIS: CAUSED BY PERFORATION OF THE APPENDIX

JAMA. 1939;113(14):1285-1288. doi:10.1001/jama.1939.02800390007003
Abstract

In February 1935 we made a statistical and critical analysis of forty-four cases of diffuse peritonitis following perforation of the appendix treated at the Buffalo General Hospital and Buffalo Children's Hospital. In this series of cases there were twenty deaths, or a mortality rate of 45.4 per cent, in two institutions which represented a cross section of the average hospital in this country.

In addition, we obtained the following information: Ninety-seven per cent of the patients were operated on by six different surgeons, and no uniformity of treatment existed. We believe that, omitting surgical judgment, which is a personal and individual equation that cannot be evaluated, the chief means available to combat peritonitis is the intelligent use of morphine, fluids, duodenal decompression and transfusion. The various surgeons used one or two of these agents to the total exclusion of the remainder, and there was no unanimity of opinion as to

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