Background: Despite improvements in treatment, secondary peritonitis is still associated with high morbidity and mortality rates. Better knowledge of reallife clinical practices might improve management. Objectives: To identify the common causes and highlight the morbidity and mortality of secondary peritonitis in Al- Jala hospital, Benghazi, Libya. Patients and Methods: Retrospective study (January 2009–August 2010) of 137 patients with secondary peritonitis is reported. Results: Appendicitis and gastroduodenal perforations were the commonest causes of secondary peritonitis, occurring in 61% and 20% of the patients respectively. Other conditions (small bowel perforations, colonic perforations, biliary peritonitis, ruptured hydatid cyst and pancreatitis) accounted for less than 20% of cases. The overall mortality rate was 4.37%. Morbidity developed in 23% of Patients. Conclusions: Acute appendicitis is the most common cause of intra-abdominal infection in our study. The clinical outcomes associated with secondary peritonitis are highly dependent upon the site of contamination (versus others), as well as local and systemic factors.

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