An Observational Study of Clinical Profile and Management of Non-Traumatic Small Bowel Perforation at Tertiary Care Centre

Somani, Kiran; Vashistha, Rishikant; Datey, Sanjay; Abhishek, G; Patel, Akhilesh Kumar

doi:10.14260/jemds/2018/804

Cited by 3 publications

(3 citation statements)

References 6 publications

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“…100% of the patients presented with a symptoms of severe abdominal pain and altered bowel habit, classical feature of peritonitis followed by fever, nausea and vomiting and abdominal distension which is comparable to study conducted in the Pakistan where majority of the patients 78%, present with the history of pain in abdomen, abdominal distention 45%, altered bowel habit 26.6%, nausea vomiting 21%, Fever 20%(total number of patient included in study was 300) [ 11 ]. And another study done by Somani et al, has also similar finding as of current study, where abdominal pain, obstipation, abdominal distension, fever and vomiting were major symptoms [ 12 ]. In the present study most common diagnostic findings on investigations was pneumoperitoneum (gas under diaphragm on X-Ray) which is comparable to the study done by Bansal et al [ 13 ] where out of the 1723 patients of documented perforation on intraoperative finding, 89.2% patients showed pneumoperitoneum on preoperative plain radiography.…”

Section: Discussionsupporting

confidence: 86%

Clinical profile and management of perforation peritonitis in Bharatpur hospital, Nepal: A prospective study

Neupane

Koirala

Kharel

et al. 2022

Annals of Medicine &Amp; Surgery

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Section: Discussionsupporting

confidence: 86%

Clinical profile and management of perforation peritonitis in Bharatpur hospital, Nepal: A prospective study

Neupane

Koirala

Kharel

et al. 2022

Annals of Medicine &Amp; Surgery

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“…Diagnosis of perforated ileum will be made using Plain supine x-rays of the abdomen (presence of air in the abdominal cavity on x-rays) along with the presenting symptoms (severe abdominal pain) and physical examination (presence of abdominal distension and tenderness) of the patient. [17][18][19] All the surgeries were done by the same team of consultant surgeons. The abdomen was closed by the same surgical team using the same surgical technique to avoid any bias.…”

Section: Methodsmentioning

confidence: 99%

Study of antibiotic resistance in patients of enteric perforation in a tertiary care hospital.

Kareem

Aftab

Hashmi

et al. 2021

TPMJ

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Objective: To study the clinical outcomes and determine the antibiotic resistance in patients of enteric perforation in a tertiary care hospital. Study Design: Cross Sectional study. Setting: Department of General Surgery at Nishtar Hospital, Multan. Period: May 2017 to December 2019. Material & Methods: Sample size was calculated to be 97 with a confidence level of 95% and margin of error of 10%. We collected data from 100 patients. All the surgeries were done by the same team of consultant surgeons. The abdomen was closed by the same surgical team using the same surgical technique to avoid any bias. All the continuous variables were reported as mean ± standard deviation. The antibiotic resistance was compared with the number of patients with wound infections, burst abdomen, ICU admissions and number of in-hospital stay days. Categorical variables were compared using Chi square test for Independence. The number of in-hospital stay days were compared using Student t-test. The results were compiled using SPSS version 20. Results: Our result indicated that a patient had a greater chance of having a burst abdomen and wound infection if there was resistance to ciprofloxacin or ceftriaxone. Similar results were obtained for ICU admissions. There was a significantly longer in-hospital stay observed for patients who were resistant to the standard regimen of Ceftriaxone. Conclusion: It seems only rationale that the patients susceptible should be treated with Imipinem for 2 weeks as the empirical therapy rather than the standard empirical therapy of ceftriaxone and ciprofloxacin. The blood cultures can be sent before starting Imipinem and treatment management plan changed if the culture results are sensitive for the empiric antibiotics.

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“…Exploratory laparotomy is considered the gold standard treatment for perforation peritonitis; nevertheless, emergency laparotomy under general anesthesia should not be performed if the patient's status has not improved after all resuscitative measures have been tried 6 . Primary peritoneal drainage (PPD) is an alternative to emergency laparotomy.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Percutaneous Peritoneal Drainage Among Patients with High Risk Perforated Peritonitis in Tertiary Care Hospitals

Noshad¹,

Ahmad²,

Iqbal³

et al. 2023

PJMHS

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Aim: The aim of this study was to evaluate the effectiveness of percutaneous peritoneal drainage (PPD) as a treatment option for high-risk perforated peritonitis in tertiary care hospitals. Methods: This prospective investigation was conducted at multiple centres including Department of Surgery, Quaid-e-Azam Medical College / Bahawal Victoria Hospital Bahawalpur and Jinnah International Hospital, Abbottabad from August, 2022 to January, 2023. Patients with peritonitis accompanied by shock or who did not respond to initial resuscitative protocols were included in the study. Patients with primary peritonitis or spontaneous bacterial peritonitis and those with a history of multiple previous abdominal surgeries were excluded. The study evaluated the effectiveness of PPD as a treatment option for high-risk perforated peritonitis. Chi Square test was applied to assess association keeping P value < 0.05. Results: The mean age was 54.81±9.2 years, male patients were 66 (57.9%) while female patients were 48 (42.1%). Regarding mortality after PPD 25 (21.9%) patients died, while 15 (13.2%) patients died after definitive surgery. Mortality after PPD was significantly associated with systolic BP < 90 mmHg and comorbid. Conclusion: Based on our study findings, we have determined that percutaneous peritoneal drainage is a crucial procedure that can potentially save lives and lead to improved outcomes in high-risk patients undergoing laparotomy. Moreover, it has the potential to enhance their preoperative condition. Keywords: High risk patients, Primary peritoneal drainage, Perforation peritonitis

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An Observational Study of Clinical Profile and Management of Non-Traumatic Small Bowel Perforation at Tertiary Care Centre

Cited by 3 publications

References 6 publications

Clinical profile and management of perforation peritonitis in Bharatpur hospital, Nepal: A prospective study

Clinical profile and management of perforation peritonitis in Bharatpur hospital, Nepal: A prospective study

Study of antibiotic resistance in patients of enteric perforation in a tertiary care hospital.

Evaluation of Percutaneous Peritoneal Drainage Among Patients with High Risk Perforated Peritonitis in Tertiary Care Hospitals

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