CLINICAL EVALUATION AND MANAGEMENT OF PERITONITIS SECONDARY TO HOLLOW VISCUS PERFORATION
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2016, Vol 5, Issue 19
Abstract
BACKGROUND Peritonitis is often caused by introduction of an infection into the otherwise sterile peritoneal environment through perforation of bowel, introduction of a chemically irritating material, such as gastric acid from a perforated ulcer. The different modes of presentation of cases may be misleading the diagnosis of its origin. Smoking and use of non-steroidal anti-inflammatory drugs are important risk factor for perforation. The objectives are to study the frequency of peritonitis secondary to hollow viscus perforation in relation to age, sex, anatomical location, symptoms and signs and its surgical management and complications of operative management. The study has been based on the analysis of 50 cases of hollow viscus perforation cases fulfilling the criteria were randomly selected. Exclusion criteria were peritonitis due to oesophagus perforation and reproductive tract perforation. The diagnosis was made with history, clinical features and erect x ray abdomen. RESULTS Duodenum was the most common site of perforation and the highest number of patients were seen in the age group of 50 years and above irrespective of pathological conditions. Most of the patients presented 48 hours after onset of clinical symptoms. Laparotomy with closure of perforation with omental patch is the commonest method of surgical management. Lower respiratory tract infection is the most common complication observed. CONCLUSIONS The majority of perforation peritonitis cases in the study comprises of duodenal ulcer perforation. The basic principles of early diagnosis, prompt resuscitation and urgent surgical interventions still forms the cornerstone in the management of these cases. Educating the health professionals at primary health center regarding early diagnosis and early referral to tertiary center should be emphasized.
Authors and Affiliations
Dinesh , Sachin , Sreekanth , Apurva
Keywords
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- EP ID EP144041
- DOI 10.14260/jemds/2016/221
- Views 77
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