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Relation to Outcome

John M. Bohnen, MD, FRCS(C); Nicolas V. Christou, MD, PhD, FRCS(C); Louise Chiasson; Irving W. DeVoe, PhD; Jonathan L. Meakins, MD, DSc, FRCS(C), FACS

Arch Surg. 1984;119(1):117-120.

Abstract
• A rat model was developed to determine if delayed hypersensitivity skin tests during early peritonitis would predict outcome. Presensitized rats were simultaneously tested intradermally with keyhole-limpet hemocyanin and given four types of fecal bacteria and 10% barium sulfate intraperitoneally. Rats were divided into four groups according to inoculum dose. Skin tests were read at 24 hours in survivors and correlated with death and abscesses during the next 19 days. In the two groups with greatest mortality, 35% of anergic rats died, compared with 0% of reactive rats. In the three groups with most abscesses, anergic rats had more abscesses than those that reacted. Overall, 90% of anergic rats died or had abscesses v only 10% of reactors. We concluded that the outcome of untreated peritonitis is determined in the first 24 hours; anergy at that time predicts death or abscess formation.

(Arch Surg 1984;119:117-120)

Author Affiliations
From the Departments of Surgery (Drs Bohnen, Christou, and Meakins and Ms Chiasson) and Microbiology (Drs Christou, DeVoe, and Meakins), McGill University and the Royal Victoria Hospital, Montreal.

Footnotes
Accepted for publication Aug 25, 1983.

Read before the Third Annual Meeting of the Surgical Infection Society, Fort Lauderdale, Fla, May 10, 1983.

Reprint requests to Royal Victoria Hospital, Room S10.30, 687 Pine Ave W, Montreal, Quebec, Canada H3A 1A1 (Dr Meakins).

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