CLINICAL STUDY AND MANAGEMENT OF PERITONITIS SECONDARY TO HOLLOW VISCOUS PERFORATION
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 36
Abstract
BACKGROUND Hollow viscous perforation causing peritonitis (Secondary) is the most common surgical emergency worldwide. Peptic ulcer perforation is being the most common cause in developing countries like India,1 whereas large bowel perforation is the most common in western countries.2-4 It needs emergency surgical intervention along with adequate initial resuscitation. Several factors play important role in prognosis and recovery which include timing of presentation, anatomical site, pathology of perforation, extremes of age and other associated co-morbid conditions. Even with development of multidisciplinary approach and advances in the management of peritonitis, mortality and morbidity due to peritonitis secondary to hollow viscous perforation remains high. MATERIALS AND METHODS It is a descriptive study. 78 cases with peritonitis due to hollow viscous perforation, as surgical emergencies underwent emergency laparotomy. Details of age, sex, anatomical location, signs and symptoms, reliability, complications and mortality were noted. RESULTS The most common age group affected is 41 - 60 years. M: F ratio is 2.71: 1. Duodenal perforations are more common in the age group of 41 - 50 years and appendicular perforations are common in the age group of 21 - 40 years. Diagnosis is made clinically and confirmed by presence of pneumoperitoneum (80%) on radiographs. All patients are subjected to emergency exploratory laparotomy along with adequate initial resuscitation. Omental patch closure of the perforation (75.64%) is the most common procedure done. Wound infection (26.92%) is the most common post-operative complication followed by respiratory complications (25.64%). 8.97% is the mortality observed in this study. CONCLUSION Patients suspected to be suffering from peritonitis secondary to hollow viscous perforation have to be diagnosed early and need immediate tertiary care management in the form of multimodality approach. For this, the health professionals at the primary care level have to be educated regarding early recognition and early referral to tertiary centres, so that morbidity and mortality can be minimised.
Authors and Affiliations
Umapathi P, Mahesh Babu G
Keywords
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- EP ID EP544979
- DOI 10.14260/jemds/2018/888
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