Causes of acute peritonitis in 1188 consecutive adult patients in Ghana

Abstract

In a five-year prospective study,1188 consecutive adult patients were admitted and treated for acute generalized peritonitis at the Surgical Emergency Unit of the Komfo Anokye Teaching Hospital, Kumasi, Ghana. Appendicitis and typhoid ileal perforation were the commonest causes, occurring in 43.1% and 35.1% of patients, respectively. Other conditions (gastroduodenal perforations, ruptured abscesses, traumatic bowel perforations and amoebic colonic perforations) accounted for fewer than 25% of cases. This paper notes that acute appendicitis and typhoid perforation remain the leading causes of peritonitis in Ghana. Compared with previous series, the importance of appendicitis in acute peritonitis has diminished. The complications of communicable diseases now cause peritonitis more commonly than 35 years ago. This may reflect deteriorating conditions of sanitation and housing during the intervening period.