A clinical study of the spectrum of gastro intestinal perforation peritonitis in a tertiary care centre


  • Dharamdev D. Department of General Surgery, Kanachur Institute of Medical Sciences, Natekal, Mangaluru, Karnataka, India
  • Rupa Merlyn Mascarenhas Department of General Surgery, A. J. Institute of Medical Sciences, Kuntikana, Mangaluru, Karnataka, India
  • Arun Kumar Department of General Surgery, A. J. Institute of Medical Sciences, Kuntikana, Mangaluru, Karnataka, India




Perforation, Laparotomy, Peritonitis


Background: Acute abdomen is one of the most common causes of emergencies which present to surgeon. Gastrointestinal perforation is third most common cause for emergency explorative laparotomy. Most of the time when patient presents to the tertiary centre, it is by clinical examination and investigation a diagnosis of perforation is established. The objective of the study was to evaluate causes, signs and symptoms, various modalities of management and possible complications which develop in gastrointestinal perforations.

Methods: 50 patients with features of perforation were chosen using purposive sampling technique. Descriptive statistics was used for analysis. Detailed history was taken, physical examination and relevant investigations were done and correlated with intra operative and histopathology report wherever possible and followed up for complications.

Results: Duodenal perforation was the most common cause of perforation accounting for 32 out of 50 cases. Surgical site infection was common complication accounting for 14 out of 50 cases.

Conclusions: Surgery remains mainstay in all perforations.


Svanes C, Lie RT, Svanes K, Lie SA, Søreide O. Adverse effects of delayed treatment for perforated peptic ulcer. Ann Surg. 1994;220(2):168-75.

Washington BC, Villalba MR, Lauter CB, Colville J, Starnes R. Cefamandole-erythromycin-heparin peritoneal irrigation: an adjunct to the surgical treatment of diffuse bacterial peritonitis. Surgery. 1983;94(4):576-81.

Shinagawa N, Muramoto M, Sakurai S, Fukui T, Hori K, Taniguchi M, et al. A bacteriological study of perforated duodenal ulcers. Jpn J Surg. 1991;21(1):1-7.

Noon GP, Beal AC, Jorden GL. Clinical evaluation of peritoneal irrigation with antibiotic solution. Surgery.1967;67:73-6.

Bose SM, Kumar A, Chaudhary A, Dhara I, Gupta NM, Khanna SK. Factors affecting mortality in small intestinal perforation. Indian J Gastroenterol. 1986;5(4):261-3.

Mewara BC, Chourashiya BK, Porwal S. A Clinical Study of the Spectrum of Gastro Intestinal Perforation Peritonitis in Rural Southern East Rajasthan. J Univer Surg. 2017;5:2.

Devi PS, Manikantan G, Chisthi M. Gastro intestinal perforation: atertiary care center experience. Int surgery J. 2017;4(2):709-13.

Meena LN, Jain S, Bajiya P. Gastrointestinal perforation peritonitis in India: A study of 442 cases. Saudi Surg J 2017;5:116-21.

Jhobta RS, Attri AK, Kaushik R, Sharma R, Jhobta A. Spectrum of perforation peritonitis in India--review of 504 consecutive cases. World J Emerg Surg. 2006;1:26.

Kemparaj T, Narasimhaiah NK, Mayigaiah RK. Our experience in gastrointestinaln perforations: a retrospective study. Int Surg J. 2017;4:593-7.

Dandapat MC, Mukherjee LM, Mishra SB, Howlader PC. Gastro Intestinal perforations. Indian J Surg.1999;53:189-93.

Shah HK, Trivedi VD: Peritonitis- Study of 110 cases. Indian Practitioner.1988;41:855-60.

Nomikos IN, Katsouyanni K, Papaioannou AN. Washing with or without chloramphenicol in the treatment of peritonitis: a prospective, clinical trial. Surgery. 1986;99(1):20-5.

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(2):170-3.

Tripati MD, Nagar AM, Srivastava RD, Pratap VK. Peritonitis- Study of factors contributing to mortality. Indian J Surg. 1993;55:342-9.






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