Title: Range and Outcome of Perforation Peritonitis at a Tertiary Care Center- A Prospective Study
Authors: Kanchan Sonelal Baitha, Prem Prakash, Anand Deoraj, Mukesh Kumar, Yogesh Kumar Yashaswi, Abhishek Chaudhary
DOI: https://dx.doi.org/10.18535/jmscr/v6i4.77
Abstract
Introduction: Acute peritonitis by perforation is the most common type and almost 80% cases results from necrosis of digestive conduit, such as typhoid fever, duodenal ulcer perforation, tubercular perforation and mesenteric ischemia secondary to the intestinal obstruction. So it is very important to seek urgent evaluation and treatment that can prevent fatal complications. This prospective study was conducted at tertiary care center to know the range of perforation in terms of etiology, presentation ,site of perforation, treatment options, postoperative complications and mortality so that we can improve its outcome in this region.
Methods: This was a prospective study conducted by the department of general surgery from September 2017 to March 2018. 39 consecutive patients of perforation peritonitis admitted to surgical emergency were included in this study. All patients were resuscitated and underwent emergency exploratory laparotomy. On laparotomy, cause of perforation was identified and managed accordingly.
Results: The mean age of patients was 34.9 years (range 15-75 years).The majority of patients were male (76%). Perforated duodenal ulcer due to acid-peptic disease and small bowel perforation due to typhoid were the most common cause of perforation peritonitis. Tubercular perforation was second most common cause of small bowel perforation. Post- operative complications included wound infection (31%), anastomotic leak (8%),burst abdomen (13%) ,Pneumonia( 25%),septicemia (8%),Acute renal failure (6%) and abdominal collection in (9%) .
Conclusion: Peritonitis due to perforation is still a terrible and alarming condition encounter to general surgeon in emergency. Early arrival of patients to hospital and adequate Resuscitation before surgery improves outcome of disease. Avoidance of extensive emergency surgery contributes to low mortality.
Keywords: Perforation peritonitis, Exploratory laparotomy, outcome.
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