Peritoneal/ Serum Lactate Ratio in Relaparotomy

Post operative intraabdominal sepsis due to surgical complications is associated with an important mortality and morbidity. Early diagnosis is crucial to improve outcome. Relaparotomy could be necessary to eradicate the intraabdominal focus of sepsis or hypoperfusion. The relaparotomy must be performed early after the diagnosis of surgical complications before the onset of multi organ failure. This prospective observational study includes the post operative period of consecutive patients requiring both major elective surgery and urgent laparotomy. Demographic data, presence and nature of underlying disease and surgical diagnosis will be recorded on admission and study inclusion. Daily after study inclusion, the investigators measure: venous blood gases, blood lactate and lactate presents in the fluid collected from the abdomen. Possum and SAPSII scores will be calculated daily or when a patient develops a rapid clinical deterioration. The investigators follow patients with complicated or uncomplicated post operative period. Post operative complications are defined as: mesenteric ischemia, need for reintervention, anastomotic leakage or fistula, secondary peritonitis and death. The primary end point is to demonstrate the correlation between surgical complications and serum/abdominal lactate ratio. The second end point is to verify the correlation between need to relaparotomy and Possum an SAPSII scores.