European Journal of Molecular & Clinical Medicine

Abstract

Introduction: Peritonitis is defined as inflammation of the serosal membrane that lines abdominal cavity and organs contained therein. Secondary peritonitis caused due to non-traumatic hollow viscous perforation is a common occurrence in this country which requires emergency surgical intervention. In our prospective study we tried to find out the incidence of perforative peritonitis which presented to our tertiary care hospital with respect to age and gender, relative frequency of anatomical site of perforation, their causes, presentation, treatment and outcome.
Methods: The study has been based on the analysis of 98 cases of non-traumatic perforated peritonitis patients admitted to our tertiary hospital, during the study period with prior inclusion criteria.
Each patient was examined thoroughly, after taking a detailed history and social demographic factors were noted. Cases were admitted as emergency and relevant immediate investigations were done. The diagnosis was made with history, clinical features and radiology to support the diagnosis.
Out of 98 cases, 92 underwent emergency laparotomy, at laparotomy the site of perforation, its pathological conditions, the amount of peritoneal contamination were noted. Perforation site specific operative procedures were done. In post-operative period, patients were closely monitored and complications were managed appropriately.
Results: Out of 98 cases 84(85.7%) were males. 25(32.7%) of the patients were in a age group of 21-30 years. Majority (35.7%) of the cases presented after 24-48 hours to our hospital. Pain abdomen was the most consistent symptom present in all the cases. Smoking (43.12%) and NSAIDs(21.4%) were the most important risk factors. Duodenum was the most common site of perforation (43.9%) followed by ileal (24.5%) and gastric (21.4%). In postoperative period 34.3% of patients had some form of complication and death occurred in 8 patients (8.16%).
Conclusion: Non-traumatic perforative peritonitis is more common in young age group (21-30 years) with male preponderance and is more common in rural population. Smoking and NSAIDs are the most common causative factors although it is multifactorial. Peptic ulcer disease is the most common cause of perforation. Delayed presentation to the hospital is the most common cause of morbidity and mortality