A study of clinical profile and management of perforation peritonitis in a tertiary health centre located in Central India
DOI:
https://doi.org/10.18203/2349-2902.isj20170847Keywords:
Appendicular, Morbidity, Mortality, Perforation Peritonitis, Peptic ulcer, Typhoid, TubercularAbstract
Background: Perforation peritonitis is the most common surgical emergency in India. The spectrum of etiology of perforation in tropical countries continues to be different from its Western counterpart. The objective of the study was to highlight the spectrum of perforation peritonitis as encountered by us at RKDF medical college and research centre, Bhopal, Madhya Pradesh, India.
Methods: Our prospective observational study was conducted at Department of General Surgery, R.K.D.F. Medical College and Research Centre, Bhopal, Madhya Pradesh, India during period of August 2013 to August 2015. Total 110 cases of perforation peritonitis were included. Patient detailed history, symptoms, sign, blood investigation finding, cause of perforation, site of perforation, type of surgery, post-operative complications and mortality were assessed and result were compared with other studies.
Results: The most common cause of perforation in our series was perforated peptic ulcer (52 cases) followed by typhoid fever perforation (21 cases), appendicular (16 cases) and tuberculosis (11 cases). Despite delay in seeking medical treatment, the overall mortality (16.36%) was comparable with other published series though the overall morbidity (63%) was unusually high.
Conclusions: In contrast to western literature, where lower gastrointestinal tract perforations predominate, upper gastrointestinal tract perforations constitute the majority of cases in Central India.
Metrics
References
Nannini LD, Leo D. An analysis of acute perforated peptic ulcer. Permonente Foundation Medical Bulletin. 1944;1:1-11.
Edino ST, Yakubu AA, Mohammed AZ, Abubaka IS. The prognostic factors in typhoid ileal perforation: a prospective study of 50 patients. J Natl Med Assocv. 2007;99(9):1042-5.
Lee FY, Leung KI. Predicting mortality and morbidity of patients operated on for perforated peptic ulcers. Arch Surg. 2001;136(1):90-4.
Boey J, Wong J, Ong GB. A prospective study of operative risk factors in perforated duodenal ulcers. Ann Surg. 1982;195(3):256-9.
Crofts TJ, Park KG, Steels RJ. A randomized trial of non operative treatment for perforated peptic ulcer. N Engl J Med. 1989;320(15):970-3.
Sillakivi T, Lang A. Evaluation of risk factors for mortality in surgically treated perforated peptic ulcer. Hepatogasterology. 2000;47(36):1765-8.
Tonnessen T, Carlsen E. Perforated ulcer. Tidsskr Nor Laegeforen. 2001;121(7):790-2.
Mock CN, Amaral J, Visser LE. Improvement in survival from typhoid ileal perforation results of 221 operative cases. Ann Surg. 1992;215(3):244-9.
Bhansali SK. Gastrointestinal perforations-a clinical study of 96 cases. J Postgrad Med. 1967;13:1-12.
Rao DCM, Mathur JC, Ramu D, Anand D. Gastrointestinal tract perforations. Indian J Surg. 1984;46:94-6.
Shah HK, Trivedi VD. Peritonitis a study of 110 cases. Indian Practitioner. 1988;41:855-60.
Sharma L, Gupta S. Generalized peritonitis in India-the tropical spectrum. Jpn J Surg. 1991;21(3):272-7.
Dandapat MC, Mukherjee LM, Mishra SB, Howlader PC. Gastrointestinal perforations. Indian J Surg. 1991;53:189-93.
Chen SC, Lin FY, Hsieh YS, Chen WJ. Accuracy of ultrasonography in the diagnosis of peritonitis compared with the clinical impression of the surgeon. Arch Surg. 2000;135:170-4.
Quereshi AM. Predictive power of mannheim peritonitis index. JCPSP. 2005;15:693-6.
Nishida T. Postoperative hyperbilirubinemia after surgery for gastrointestinal perforation. Surgery Today. 2002;32:679-84.
Wakayama T. Risk factors influencing the short-term results of gastroduodenal perforation. Surg Today. 1994;24:681-7.
Sugimoto K. Mechanically assisted intraoperative peritoneal lavage for generalized peritonitis as a result of perforation of the upper part of the gastrointestinal tract. J Am Coll Surg. 1994;179:443-8.
Mehendale VG, Samsi AB. Jejuno-ileal perforations. J Postgrad Med. 1979;25:41-7.
Nadkarni KM. Small bowel perforations a study of 32 cases. Arch Surg. 1981;116:53-7.
Bose SM, Kumar A, Chaudhary A, Dhara I, Gupta NM, Khanna SK. Factors affecting mortality in small intestinal perforation. Indian J Gastroenterol. 1986;5:261-3.
Ray D, Sen T, Mukherjee AL, Gupta A. Small bowel perforation. Trop Doct. 2001;31:119-20.
Chitkara N, Gupta R, Singla SL, Bansal V. Small bowel perforation. Trop Doct. 2002;32:186.
Meyer C, Rochas M, Rohr S. Perforation of the colon apropos of 74 cases. J Chir. 1989;126(10):501-6.
Hermansson M, Holstein SC, Zilling T. Surgical approach and prognostic factors after peptic ulcer perforation. Eur J Surg. 1999;165(6):566-72.
Downloads
Published
How to Cite
Issue
Section
