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Spectrum of Perforation Peritonitis in Delhi: 77 Cases Experience

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Abstract

Perforation peritonitis is the most common surgical emergency encountered by surgeons all over the world as well in India. The spectrum of etiology of perforation peritonitis in tropical countries continues to differ from its western counterpart. This study was conducted at Hindu Rao Hospital, Municipal Corporation of Delhi, New Delhi, India, designed to highlight the spectrum of perforation peritonitis in the eastern countries and to improve its outcome. This prospective study included 77 consecutive patients of perforation peritonitis studied in terms of clinical presentations, causes, site of perforation, surgical treatment, postoperative complications, and mortality at Hindu Rao Hospital, Delhi, from March 1, 2011 to December 1, 2011, over a period of 8 months. All patients were resuscitated and underwent emergency exploratory laparotomy. On laparotomy cause of perforation peritonitis was found and controlled. The most common cause of perforation peritonitis noticed in our series was perforated duodenal ulcer (26.4 %) and ileal typhoid perforation (26.4 %), each followed by small bowel tuberculosis (10.3 %) and stomach perforation (9.2 %), perforation due to acute appendicitis (5 %). The highest number of perforations was seen in ileum (39.1 %), duodenum (26.4 %), stomach (11.5 %), appendix (3.5 %), jejunum (4.6 %), and colon (3.5 %). Overall mortality was 13 %. The spectrum of perforation peritonitis in India continuously differs from western countries. The highest number of perforations was noticed in the upper part of the gastrointestinal tract as compared to the western countries where the perforations seen mostly in the distal part. The most common cause of perforation peritonitis was perforated duodenal ulcer and small bowel typhoid perforation followed by typhoid perforation. Large bowel perforations and malignant perforations were least common in our setup.

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Acknowledgments

I am thankful to Dr D.R. Meena for critical review of manuscript.

Competing Interests

The authors declare that they have no competing interests.

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Authors and Affiliations

  1. Hindu Rao Hospital, Malka Ganj, Delhi, India

    Dinesh Yadav & Puneet K. Garg

Authors
  1. Dinesh Yadav
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  2. Puneet K. Garg
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Correspondence to Dinesh Yadav.

Additional information

Perforation peritonitis is a common surgical emergency allover world. In india typhoid and tubercular perforation are common.

Hindurao hospital is biggest hospital of municipal corporation of delhi having tertiary care facilities. This hospital has 24 h emergency, surgical ICU and senior surgeons on emergency call duty. The perforation patientsa are managed according to general condition and operative finding of patient either- primary repair, resection anastomosis or stoma formation.

77 patients included in this study having GI perforations.

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Yadav, D., Garg, P.K. Spectrum of Perforation Peritonitis in Delhi: 77 Cases Experience. Indian J Surg 75, 133–137 (2013). https://doi.org/10.1007/s12262-012-0609-2

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  • DOI: https://doi.org/10.1007/s12262-012-0609-2

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