Perforation Peritonitis and the Developing World

Bali, Rajandeep Singh; Verma, Sanjeev Kumar; Agarwal, PN; Singh, Rajdeep; Talwar, Nikhil

doi:10.1155/2014/105492

Cited by 65 publications

(78 citation statements)

References 13 publications

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“…Peptic ulcer perforation is the most common cause for perforation peritonitis. 15,16 Most of the patients in our study i.e. 38 patients (84.5%) were male which is similar to other studies.…”

Section: Discussionsupporting

confidence: 90%

Clinical study and management of peritonitis secondary to perforated peptic ulcer

2017

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Background: Perforated peptic ulcer is the most common cause among all causes of gastrointestinal tract perforation which is an emergency condition of the abdomen that requires early recognition and timely surgical management. Peptic ulcer perforation is associated significant morbidity and mortality. The aim of study is to evaluate the incidence, clinical presentation, management and outcomes of the patient with peptic ulcer perforation undergoing emergency laparotomy.Methods: This retrospective study includes 45 patients who were operated for perforated peptic ulcer peritonitis at Bundelkhand Medical College and Associated Hospital, Sagar from March 2015 to April 2017. Paediatric patients of age less than 14 years, patients presenting as recurrent perforation were excluded from the study. A detailed history, clinical presentation and routine investigations were done in all cases.Results: In the present study, most of the patients were male. Most of these patients presents with clinical signs of peritonitis between 24-48 hours after onset of the pain. Among the patients of peptic ulcer perforation, duodenal perforation (93.3%) is more common and which is the most common cause of perforation peritonitis. The diagnosis is made clinically and confirmed by presence of gas under diaphragm on radiograph. Exploratory laparotomy with simple closure of perforation with omental patch was done in all cases. The most common post-operative complication was wound infection (57.5%). The overall mortality was 11.1%.Conclusions: Late presentation of peptic ulcer perforation is common with high morbidity and mortality. Surgical intervention with Graham’s omentopexy with broad spectrum antibiotics is still commonly practiced.

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Section: Discussionsupporting

confidence: 90%

Clinical study and management of peritonitis secondary to perforated peptic ulcer

2017

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“…We found that surgery within the first six hour after diagnosis of perforation peritonitis had good outcomes in relations of earlier resumption of normal diet , shortening the length of stay in hospital and length of stay in ICU. Our overall mortality rate was 10%, which is lower [4][5][6][7] than reported by other studies. In comparision to early intervention patients, late intervention patients develop more postoperative complications (34.3 % vs. 17.8%, P=0.022).…”

Section: Discussioncontrasting

confidence: 76%

Effect of Early Surgery on Outcome In Perforation Peritonitis

Bhandari¹,

Poudel²,

Chandra³

2018

J Univ Coll Med Sci

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“…These observations were similar to studies of Bali RS showing mean age 37.8 years and male to female ratio of 2.1:1. 15 Similarly, Malik P also showed mean age 32 years and male to female ratio 2.8:1. 16 As many as 40 (80%) cases included in the present study, belonged to the low socioeconomic status (Table 1).…”

Section: Discussionmentioning

confidence: 89%

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

Malik¹,

Singh

Sidhu

et al. 2018

Int Surg J

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Background: Perforation peritonitis constitutes one of the most common surgical emergencies encountered by surgeons. Even with modern treatment, diffuse peritonitis carries a high morbidity and mortality rate.Methods: The prospective study was conducted at department of surgery on 50 patients of perforation peritonitis admitted in emergency department of hospital. Detailed history, clinical examination and investigations were carried out. Patients were operated upon and findings were noted. Comparisons were done for postoperative ICU stay, morbidity/ mortality, oral feed and total hospital stay between the patients who reported within 24 hours and after 24 hours of onset of symptoms to determine golden period for operative intervention.Results: Out of total 50 patients, 21(42%) patients presented within 24 hrs of onset of first symptom of perforation while 29(58%) patients presented after 24 hours. Postoperative ICU stay, morbidity/ mortality, delay in oral feed and total hospital stay was statistically more in patients presenting after 24 hours.Conclusions: It can be concluded that the golden period of 24 hrs between the onset of symptom and start of treatment is the most important factor to determine the outcome.

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Perforation Peritonitis and the Developing World

Cited by 65 publications

References 13 publications

Clinical study and management of peritonitis secondary to perforated peptic ulcer

Clinical study and management of peritonitis secondary to perforated peptic ulcer

Effect of Early Surgery on Outcome In Perforation Peritonitis

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

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