Goal: To study the diagnostic difficulties and post-operative morbidity and mortality of peritonitis. Patients and Methods: Retrospective study about the records of adult patients operated on between 1999 and 2013 whose diagnosis of post-operative peritonitis was made. Results: We achieved 23,573 lanterns and recorded 148 cases of postoperative peritonitis or 0.62%. The medium age was 37.1 ± 17.7 years and the sex ratio was 1.2. The delay between the initial intervention and reoperation was less than 5 days. Factors occurrence of postoperative peritonitis were those related to the initial surgery: septic context 70.8%, emergency surgery 81.1% under the seat mesocolic 25% and 20.3% initial surgical technique. The diagnosis was made preoperatively in 62.2% (n = 92). Ultrasound has found an effusion in 29.7% (n = 44). Cytobactériologic review identified germs in 85.1% (n = 126) and sterile in 12.9% of patients (n = 22). The most frequent etiologies were: 22.9% anastigmatic leak (n = 34), the phoenix abscess in 17.6% (n = 26), iatrogenic perforation 13.5% (n = 20) and digestive fistula 25% (n = 37). Other causes were the stoical necrosis 12.2% (n = 18) and evisceration 8.8% (n = 13). We performed a digestive stoma in 61% (n = 89), a closure of the abdomen bolsters in 8.8% (n = 13), a suture in iatrogenic perforation in 13.5% (n = 20) and washing with drainage in patients with phoenix abscess in 17.6% (n = 26). Morbidity was 22.3% and 53.4% mortality. Conclusion: The diagnosis of post-operative peritonitis is difficult in a developing country. Morbidity and mortality is high. Improved diagnostic tools are needed.
 Montravers, P., Gauzit, R., Muller, C., Marmuse, J.P., Fichelle, A. and Desmonts, J.M. (1996) Emergence of Antibiotic-Resistant Bacteria in Cases of Peritonitis after Intraabdominal Surgery Affects the Efficacy of Empirical Antimicrobial Therapy. Clinical Infectious Diseases, 23, 486-494.
 Roehrborn, A., Thomas, L., Potreck, O., Ebener, C., Ohmann, C., Goretzki, P.E., et al. (2002) The Microbiology of Postoperative Peritonitis. Clinical Infectious Diseases, 33, 1513-1519.
 Dellinger, E., Wertz, M., Meakins, J., Solomkin, J., Allo, M. and Howward, H. (1985) Surgical Infection Stratification System for Intra-Abdominal Infection. Archives of Surgery, 120, 21-29.
 Hutchins, R.R., Gunning, M.P., Lucas, D.N., et al. (2004) Relaparotomy for Suspected Intraperitoneal Sepsis after Abdominal Surgery. World Journal of Surgery, 28, 137-141.
 Mariette, C. (2006) Principes de prise en charge chirurgicale des péritonites post opératoires. Journal de Chirurgie, 143, 84-87. http://dx.doi.org/10.1016/S0021-7697(06)73619-5
 Wittgrove, A.C. and Clark, C.V. (2000) Laparoscopic Gastric Bypass, Roux en-y, 500 Patients: Techniques and Results with 3-6 Months Follow up. Obesity Surgery, 10, 233-239.
 Robert, R., Hutchins, M.S., Paul Gunning, M., et al. (2004) Relaparotomy for Suspected Intraperitoneal Sepsis after Abdominal Surgery. World Journal of Surgery, 28, 137-141.
 Bader, F.G., Schroder, M., Kujath, P., et al. (2009) Diffuse Postoperative Peritonitis—Value of Diagnostic Parameters and Impact of Early Indication for Relaparatomy. European Journal of Medical Research, 14, 491-496. http://dx.doi.org/10.1186/2047-783X-14-11-491
 Augustin, P., Kermarrec, N., Muller-Serieys, C., et al. (2010) Risk Factors for Multidrug Resistant Bacteria and Optimization of Empirical Antibiotic Therapy in Postoperative Peritonitis. Critical Care, 14, R20.
 Bohnen, J., Boulanger, M., Meakins, J. and Mc Lean, P. (1983) Prognosis in Generalised Peritonitis: Relation to Cause and Risk Factors. Archives of Surgery, 118, 285-290.
 Degremont, R., Brehant, O. and Fuks, D. (2011) Prise en charge des péritonites sus-mésocoliques postopératoires par drainage de Lévy (drain hélisonde). Journal de Chirurgie Viscérale, 148, 327-335. http://dx.doi.org/10.1016/j.jchirv.2011.03.014
 Chichom, A., Tchounzou, R., Essomba, A., et al. (2009) Ré interventions de chirurgie abdominale en milieu défavorisé: Indications et suites opératoires (238 cas). Journal de Chirurgie, 146, 387-391.