DOI: http://dx.doi.org/10.18203/2349-2902.isj20182772

An analytical study of acute abdomen in established cases of pneumoperitoneum

E. Prabhu, S. Lakshmibady

Abstract


Background: Pneumoperitoneum refers to the presence of air within the peritoneal cavity. The most common cause is a perforation of the abdominal viscous, a perforated ulcer, although a pneumoperitoneum may occur as a result of perforation of any part of the bowel. The exception is a perforated appendix, which seldom causes a pneumoperitoneum. The aim of present investigation was to know the various clinical features of acute abdomen in established cases of pneumoperitoneum and to study the various surgical techniques used in the management.

Methods: This study is an analytical study of 103 patients admitted in emergency surgical wards. The relevant history, clinical examination, relevant investigations, and treatment were obtained by pretested proforma.

Results: The symptoms such as abdominal pain, abdominal distension, fever, and vomiting were present in our study. The most common symptom was an abdominal pain in almost all cases the overall mortality in our study was 6.79% most of them is due to colonic and duodenal perforations. In most of the cases, the cause of death was diagnosed as septicemia.

Conclusions: The incidence of GI Perforations can be reduced by educating the patients with appropriate medical management of peptic ulcer, tuberculosis, typhoid fever and also avoiding factors such as smoking and Alcohol.


Keywords


Alcohol, Gastric ulcer, Pneumoperitoneum, Perforations, Smoking

Full Text:

PDF

References


Walder AD, Aitkenhead AR. Role of vasopressin in the hemodynamic response to laparoscopic cholecystectomy. Br J Anaesth. 1997;78(3):264-6.

Clarke HC. History of endoscopic and laparoscopic surgery. World J Surg. 2001;25:967-8.

Dubois F, Icard P, Berthelot GA, Levard H. Coelioscopic cholecystectomy. Preliminary report of 36 cases. Ann Surg. 1990;211(1):60.

Dunker MS, Stiggelbout AM, Van Hogezand RA, Ringers J, Griffioen G, Bemelman WA. Cosmesis and body image after laparoscopic-assisted and open ileocolic resection for Crohn's disease. Surg Endoscop. 1998;12(11):1334-40.

Fleshman JW, Nelson H, Peters WR, Kim HC, Launch S, Bourse RR, et al. Early results of laparoscopic surgery for colorectal cancer. Retrospective analysis of 372 patients treated by Clinical Outcomes of Surgical Therapy (COST) Study Group. Dis Colon Rectum 1996:39:853-8.

Goldberg JM, Maurer WG. A randomized comparison of gasless laparoscopy and CO2 pneumoperitoneum. Obstet Gynecol. 1997;90(3):416-20.

Hein HT, Joshi GP, Ramsay MA, Fox LG, Gawey BJ, Hellman CL, et al. Hemodynamic changes during laparoscopic cholecystectomy in patients with severe cardiac disease. J Clin Anesthes. 1997;9(4):261-5.

Hirvonen EA, Nuutinen LS, Vuoltecnaho O. Hormonal responses and cardiac filling pressures in head-up or head- dov.rn position and pneumoperitoneum in patients undergoing operative laparoscopy. Br J Anaesth. 1997:78:128-33.

Hirvonen EA, Poikolainen EO, Pääkkönen ME, Nuutinen LS. The adverse hemodynamic effects of anesthesia, head-up tilt, and carbon dioxide pneumoperitoneum during laparoscopic cholecystectomy. Surg Endosco. 2000;14(3):272-7.

Kaiser AM, Corman MI. History of laparoscopy. Surg Oncol Clin N Amer. 2001;10:483-92.

Karayiannakis AJ, Makri GG, Matsuoka A, Karousos D, Karatzas G. Systemic stress response after laparoscopic or open cholecystectomy: a randomized trial Br J Surg. 1997;84:467-71.

Koivusalo AM, Kellokumpu I, Scheinin M, Tikkanen I, Halme L, Lindgren L. Randomized comparison of the neuroendocrine response to laparoscopic cholecystectomy using either conventional or abdominal wall lift techniques. Br J Surg. 1996;83:1532-6.

Litynski GS, Paolucci V. Origin of laparoscopy: coincidence or surgical interdisciplinary thought? World J Surg. 1998;22:899-902.

Mouret P. How I developed laparoscopic cholecystectomy. Ann Acad Med Singapore. 1996;.25:744-7.

Ratner LE, Ciseck LJ, Moore RG, Cigarroa FG, Kaufman HS, K.avoussi LR. Laparoscopic live donor nephrectomy. Transplantation-Balitmore. 1995:60(9):1047-9.

Reynolds W. Jr. The first laparoscopic cholecystectomy. J Soc Laproendoscop Surg. 2001:5(1):89-94.

Sites C, Wiezer MJ, Eijsbouts QA, Beelen RH, van Leeuwen PA, von Blomberg BM, et al. A prospective randomized study of the systemic immune response after laparoscopic and conventional Nissen fundoplication. Surgery. 1999:126:5-9.

Steiner CA, Bass EB, Talamini MA, Pitt HA, Steinberg EP. Surgical rates and operative mortality for open and laparoscopic cholecystectomy in Maryland. N Engl J Med. 1994:330:403-8.

Tanoue K, Okita K, Akahoshi T, Konishi K, Gotoh N, Tsutsumi IN, et al. Laparoscopic splenectomy for hematologic diseases. Surgery. 2002:131:318-23.

Temple LK, Litwin DE, McLeod RS. A meta-analysis of laparoscopic versus open appendectomy in patients suspected of having acute appendicitis Canadian J Surg. 1999 Oct;42(5):377.