A prospective study to assess clinical profile and golden period for operative intervention in patients with perforation peritonitis

Malik, Sandeep; Singh, Amandeep; Sidhu, Darshan Singh; Nagpal, Nitin; Sharma, Deepika

doi:10.18203/2349-2902.isj20181136

Cited by 3 publications

(6 citation statements)

References 11 publications

(19 reference statements)

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“…This observation is consistent with results of available literature which showed that most of the series from India have reported male preponderance in secondary peritonitis [7][8][9][10]. Malik et al showed a ratio of male to female to be 5.25:1 [12]. Yadav et al [13] in their study at Delhi reported a male to female ratio of 4.9:1.…”

Section: Discussionsupporting

confidence: 89%

“…Yadav et al [13] and Mabewa et al [27] reported wound dehiscence in 3.9 and 11.34% of patients, while surgical site infection rates were 19.5 and 18.6%, respectively. In another study by Malik et al [12], 42% of their patients developed postoperative complications with wound infection in 38% of patients, pneumonia in 24%, and burst abdomen in 12% of patients. In our study we observed that the complication rate was higher in patients with enteric perforation which was 33.33% followed by peptic ulcer disease in 19.49% of cases.…”

Section: Discussionmentioning

confidence: 91%

“…We did not observe any Omental patch leakage after Omental patch repair of perforation. In a study by Malik et al [12], the most common operative procedure for gastric and duodenal ulcer perforation was Omental patch repair, i.e., in 40% of patients. A study by Patil et al [19] also reported omental patch repair as most common procedure and was considered preferred surgical method of closure as it is easy to perform and technically simple and gives comparable results to that of definitive surgery in peptic ulcer perforations.…”

Section: Discussionmentioning

confidence: 99%

“…In our study, mortality was comparatively low which might be due to the facts that majority of our patients were of younger age group, without many comorbidities, more were having peptic ulcer perforations as compared with colonic perforations, and prompt resuscitation was followed by early surgery. 151(6.7) 1(6.7) 0(0) 0(0) 0(0) Enteric perforation (12) 4(33.3) 0(0) 0(0) 0(0) 0(0) Malignancy (2) 0(0) 0(0) 0(0) 2(100) 0(0) Trauma (6) 0(0) 1(16.7) 0(0) 0(0) 0(0) Total (153) 11(7.2) 12(7.8) 4(2.6) 2(1.3) 3(1.9)…”

Section: Discussionmentioning

confidence: 99%

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Generalized Secondary Peritonitis in a Teaching Hospital: a Clinical Profile

Kumar¹,

Bharti²,

Verma³

et al. 2020

SN Compr. Clin. Med.

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Inflammation of the peritoneum and peritoneal cavity, usually caused by a localized or generalized infection, is called peritonitis. The common causes of secondary peritonitis are peptic ulcer perforation, acute appendicitis, colonic diverticulitis, and PID. The present study aimed to determine the etiology, clinical presentation, and treatment outcome and identify the factors responsible for the poor outcome in the patients with generalized secondary peritonitis at Department of Surgery, Dr. RPGMC Kangra at Tanda, HP, India. The study enrolled 153 patients admitted to the surgery department with a diagnosis of acute generalized secondary peritonitis within a period of 1 year from December 2016 to November 2017. After admission, detailed history was recorded. The data regarding possible etiology, duration of symptoms, clinical presentation, diagnostic procedures, surgery performed, comorbidities, postoperative morbidity, and mortality was recorded. The age of patients ranged from 12 years to 90 years with a mean age of 42.75 years. Male/female ratio in our study was 6.29:1. Pain abdomen, fever, abdominal distension, abdominal guarding, and rigidity were the major signs and symptoms in our study. Of the patients, 65.36% presented after 24 h of onset of symptoms. Of the patients, 13.76% were having comorbidities, where respiratory disease was the most common one. Pneumoperitoneum on erect chest X-ray was found in 88.23% of the patients. Peptic ulcer disease was the commonest etiology of secondary peritonitis followed by enteric fever-associated perforation. Exploratory laparotomy and omental patch closure (Cellan jones and Modified Graham) were the most common surgery done. Postoperative morbidity was seen in 20.9% of our patients. We observed that the complication rate was higher in patients with enteric perforation (33.3%), followed by peptic ulcer disease, in 19.5% cases. To conclude, secondary peritonitis in India continues to have different spectrum as compared with Western countries with peptic ulcer disease as the most common etiology. Omental patch repair may be the preferred procedure for peptic ulcer perforation as it is technically easy and has better results. A prompt diagnosis, aggressive resuscitation, and timely surgical intervention are life-saving for all patients with generalized secondary peritonitis.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Generalized Secondary Peritonitis in a Teaching Hospital: a Clinical Profile

Kumar¹,

Bharti²,

Verma³

et al. 2020

SN Compr. Clin. Med.

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“…In a research by Ranju Singh et al among 84 patients 100% who died had symptoms more than 3 days [26]. Timing of presentation over 24 hours was found to be a signi cant factor in developing of post-operative mortality and morbidity [25].…”

Section: 22% -----------mentioning

confidence: 99%

Causal Factors and Delayed Referral of Patients of Acute Secondary Peritonitis at Herat Regional Hospital-2018-2019; a Retrospective Study

Faqiri¹,

Fazli²,

Kiani³

2021

Preprint

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Background: acute secondary peritonitis is an inflammation of the peritoneum. Surgeons in this field face this deadly pathology, and in Afghanistan, where health services have not yet been systematically standardized, the establishment of this pathology is more likely to be challenging. The aim of this study was to address the most causal factors as well as causes of delayed referral of acute secondary peritonitis at the only tertiary referral hospital in west region of Afghanistan, Herat Regional Hospital. Results: 496 patients were operated with diagnosis of acute secondary peritonitis. 58% of patients were male and the highest age group were being from 10-19 years old (32.25%). 75.21% of these patients had a delay of more than 24 hours from the onset of the first complaint to laparotomy with the highest number (23.18%) delays for 3 days, even 2 patients had symptoms for 31 to 60 days (0.40%). The most common symptoms were abdominal pain with 97%, followed by nausea and vomiting 81% and anorexia 74%. Among all pathologies, acute appendicitis was the most common cause of peritonitis (64.5%) followed by small bowel perforation (9.7%) and peptic ulcer perforation (8.5%). According to late referral 79% started medical treatment after consulting a general doctor, 15% didn’t come to health facilities due to long distances and 6% started home treatment due to wrong believes. Conclusion: According to our research, there is still some acute abdomen patients who come late to health facilities and this is because of the limited resources, cultural issues and lack of the knowledge of the general doctors. In order to decrease the number of these patients we need to expand knowledge of both patients and health staffs, in another word consulting abdominal pain patients should be obligatory by surgeons.

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