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Spectrum of perforation peritonitis at a tertiary healthcare centre: A prospective cohort study of 1908 cases

  • Original Article
  • Published:
Hellenic Journal of Surgery

Abstract

Introduction

Perforation peritonitis is one of the most common surgical emergencies encountered by general surgeons in India. The spectrum of aetiology of perforation differs from its western counterpart. This prospective study conducted at a tertiary healthcare centre was designed to highlight the spectrum of perforation in terms of aetiology, presentation site of perforation, surgical treatment and postoperative complications so as to improve its outcome in our region.

Methods

This was a single-centre prospective cohort study conducted by the department of surgery from January 2001 to December 2014. In total, 1908 consecutive cases of perforation peritonitis admitted to surgical unit 6 were recruited in the study. Continuous variables are presented as mean ± SD, and categorical variables are presented as absolute numbers and percentages.

Results

The mean age of the patients was 34.42 years (range 18 to 60 years) and the standard deviation was ± 11.10. The majority of patients were male (77.6%). Perforated duodenal ulcer due to acid-peptic disease and small bowel perforation due to typhoid were the most common causes of perforation peritonitis, followed by small bowel tubercular perforations. Postoperative complications included wound infection 18.4%, wound dehiscence 3.9%, respiratory complications 10.5%, septicaemia 5.2%, and abdominal collection 3.9%.

Conclusion

Perforation peritonitis is still a dreadful disease. Malignancy is a rare cause in our region. Resuscitation before surgery improves outcome. The formation of only a stoma in bowel perforations and omentopexy in the stomach and duodenum perforations rather than extensive emergency surgery contribute to low mortality.

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Authors and Affiliations

  1. Department of General Surgery, Lady Hardinge medical college, New Delhi, India

    Ishaq Nabi, Chandrakant Munjewar, Gyan Ranjan, Shailesh Gupta, Neelam Ahirwar, Poras Chaudhary, Rajeev Kumar & Mohinder P. Arora

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  1. Ishaq Nabi
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  2. Chandrakant Munjewar
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  3. Gyan Ranjan
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  4. Shailesh Gupta
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  5. Neelam Ahirwar
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  6. Poras Chaudhary
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  7. Rajeev Kumar
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  8. Mohinder P. Arora
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Correspondence to Poras Chaudhary.

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Nabi, I., Munjewar, C., Ranjan, G. et al. Spectrum of perforation peritonitis at a tertiary healthcare centre: A prospective cohort study of 1908 cases. Hellenic J Surg 88, 181–185 (2016). https://doi.org/10.1007/s13126-016-0312-z

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  • DOI: https://doi.org/10.1007/s13126-016-0312-z

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