A Prospective Study of Perforation Peritonitis in a Tertiary Health Care Centre of Central India

Vyas, Atul; Tanwani, Rahul; Raghuvanshi, Rakesh Singh; Khantal, Nikhil

doi:10.21276/aimdr.2017.3.2.sg14

Cited by 4 publications

(9 citation statements)

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“…12 There is some variations observed in previous studies where duodenal perforation found to be the commonest cause of perforation. 8,11,13 Gastro-duodenal perforation was commonest site of perforation followed by appendicular and ileal perforation in our study which is constant with previous studies. 7,12 In contrast some studies also show small bowel perforation as the commonest site.…”

Section: Discussionsupporting

confidence: 90%

“…17,18 Overall mortality rate was low 7.4% in present series of study of 108 cases, which was also noticed in previous studies. 7,9,11,13 In contrast mortality rate is 15-30% is observed various other studies. 12,18…”

Section: Discussionmentioning

confidence: 71%

“…8 In a report of 227 patients studied revealed predominant presentation with acute abdomen (100%), followed by abdominal distention (88%), constipation (84%), vomiting (64%), and fever (34%). 11 Other study of 93 cases also presented commonly with signs and symptom of pain in abdomen (100%) cases, followed by abdominal distention (33%), vomiting (54%), fever (40%), constipation (34%) and shock (8%). 12 The significant presenting symptoms including abdominal pain, constipation, abdominal distension, vomiting and fever were recorded in present study are typical of peritonitis.…”

Section: Discussionmentioning

confidence: 84%

“…In the investigations, erect X-Ray chest or abdomen, revealed free gas under dome of diaphragm are diagnostic feature of perforation peritonitis which were also found in 82% patients of 227 studied cases and none of the patients with appendicular perforation show any evidence of free gas under dome of diaphragm. 11 Pneumoperitoneum was present in 71.81% patients and in contrast no free gas observed in cases of appendicular perforation. 12 Similarly other study show pneumoperitoneum in 67 (72%) cases out of 93, 13 while is in present study all cases of perforation peritonitis show free gas under dome of diaphragm.…”

Section: Discussionmentioning

confidence: 87%

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Study of Perforation Peritonitis at a Tertiary Center of Northern Tribal Belt of Chhattisgarh

Siddharth¹,

Kujur²,

Ekka³

et al. 2019

jebmh

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BACKGROUND Perforation peritonitis is one of the commonest surgical emergencies in clinical practice and often life threatening if left untreated. Post-operative complication rate is found to be high in our study, may be due to late presentation to the tertiary health center and co-morbid conditions of the patients. We wanted to evaluate the various clinical presentations, sites of perforation, surgical treatment, outcomes, postoperative complications and mortality of perforation peritonitis. METHODS This is an observational study conducted among referral cases in a tertiary care center-Government Medical College, Ambikapur, Chhattisgarh, and data collected included age, sex, clinical presentation, risk factors, radiological findings, operative findings and postoperative course of treated patients. RESULTS Out of 108 cases of perforation peritonitis studied, 80 (74.07%) were of gastric perforation, 14 (12.96%) were of duodenal perforation, 9 (8.33%) were of appendicular perforation and remaining 5 (4.62%) were of ileal perforation. Common surgery done was primary closure with omentopexy in 82 (75.92%) patients, simple primary closure was done in 16 (14.81%) patients, appendicectomy done in 9 (8.33%) patients and remaining 1 (0.92%) patient was treated with ileostomy. CONCLUSIONS Gastric perforation is found to be the most common cause of gastro-intestinal perforation leading to peritonitis. Gastric perforation was found to be more common than duodenal perforation. Late presentation to hospital is commonly associated with complications which could have been avoided with early diagnosis and aggressive treatment initiated in time.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 87%

See 2 more Smart Citations

Study of Perforation Peritonitis at a Tertiary Center of Northern Tribal Belt of Chhattisgarh

Siddharth¹,

Kujur²,

Ekka³

et al. 2019

jebmh

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show abstract

“…64% of the study population presented after 24 hours of symptom onset. 12 A largest single centre study on perforation peritonitis was carried out by Malik P over 1400 cases between January 2011 and December 2013. 62% of study population presented after 24 hours of symptom onset.…”

Section: Discussionmentioning

confidence: 99%

Clinical study of perforations among patients at a tertiary care hospital

Mahesh¹,

Reddy

Hota

2018

Int Surg J

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Background: Non-traumatic gastrointestinal perforations have received far less attention in the recent medical literature than inflammations, tumoral or traumatic lesions of solid abdominal organs. The objective is to study perforations among patients at a tertiary care hospital.Methods: Patients diagnosed as non-traumatic perforations of the internal organs as diagnosed by authors were planned to be included for the present study. Diagnosis was based on history, clinical examination, and required investigations. All such patients were included in the present study that was enrolled for the present study during the study period. Such 50 patients could be studied. Non-traumatic perforation with regard to age, sex, causes, clinical presentation, diagnostic modalities required was evaluated.Results: Most common age group involved is in 3rd to 4th decade in the present study. Male preponderance (82%) was seen; with a male to female ratio was 4.6:1. The time lapse between onset of symptoms and presentation at the hospital was more than 24 hours in 24% of the study population. Abdominal pain was the most consistent symptom and was seen in 100% of the study population in the present study followed by vomiting (52%) and fever (46%). Distended abdomen was seen in 46% of study population in the present study. Tenderness was seen in all the cases and is more prominent at the site of perforation. Guarding/rigidity and absent bowel sounds were seen in 92% of the study population. Sensitivity of imaging in detecting gas under diaphragm was 72% by USG abdomen and 80% by plain radiography.Conclusions: Risk factors for increased morbidity and mortality in the present study include older age group, delayed presentation and features of shock.

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Outcome of surgeries for non-traumatic hollow viscous perforations

Hota

Mahesh²,

Kumar

2018

Int Surg J

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Background: Patients with non-traumatic hollow viscous perforations present challenge to the surgeons and outcome depends upon location and surgeon skills. Present study was to investigate the outcome of surgeries for non-traumatic hollow viscous perforations.Methods: This is a prospective observational study carried out in surgical wards in Mamata General Hospital between October 2015 and September 2017 over a period of 02 years. Evaluation of all the patients fulfilling the inclusion and exclusion criteria with respect to history, physical findings, operative findings and postoperative complications in line with the predetermined objectives was done. Various treatment modalities available and their outcome were also evaluated.Results: Benign causes of gastrointestinal perforation constituted majority of non-traumatic gastrointestinal perforations. Peptic ulcer perforation (68%) was the major cause of gastrointestinal perforation. Most common site for non-traumatic gastrointestinal perforations was duodenum (48%). Simple closure with omental patch was the operative procedure done for all cases of peptic ulcer perforation and appendicectomy for appendicular perforation. Ileal perforations secondary to typhoid perforation were treated with resection and end-to-end anastomoses in the present study. Colonic perforation was managed with Hartmann’s procedure. Most common complication was SSI (34%). Mortality was 8% and was due to septicemia.Conclusions: Aggressive resuscitation and early meticulous surgery is required to decrease morbidity and mortality in hollow viscous perforation cases.

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A Prospective Study of Perforation Peritonitis in a Tertiary Health Care Centre of Central India

Cited by 4 publications

References 4 publications

Study of Perforation Peritonitis at a Tertiary Center of Northern Tribal Belt of Chhattisgarh

Study of Perforation Peritonitis at a Tertiary Center of Northern Tribal Belt of Chhattisgarh

Clinical study of perforations among patients at a tertiary care hospital

Outcome of surgeries for non-traumatic hollow viscous perforations

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