SPECTRUM OF PERFORATIVE PERITONITIS-A PROSPECTIVE OBSERVATIONAL STUDY

Abstract

Objectives: Peritonitis secondary to gastrointestinal perforation is a common surgical emergency that has significant mortality and morbidity rates. The aim was to study the etiologies of perforative peritonitis, treatment modalities, and treatment options. Methods: This was a prospective observational study conducted between January and December 2020. Patients with perforative peritonitis either clinically or radiologically were included in the study after obtaining informed consent. Etiology of perforation, surgical procedures, complications, and outcomes was observed and collected in preformed pro forma. Data were collected in Microsoft Excel and analyzed. Results: Out of 94 patients, 92 underwent emergency surgery. About 56.38%, (n=53/94) were in the age group of 31–60 years, 86.17%, n=81/94 were males, 79.78%, (n=75/94) presented late to the hospital, abdominal pain and tenderness were seen in all patients and pneumoperitoneum was seen in 58.51%, (n=55/94). The most common cause was peptic ulcer (46.80%, n=20/94) and the most common site of perforation was the first part of the duodenum (35.10%, n=33/94). About 84.04%, (n=79/94) of surgeries were uneventful while surgical site infection was the common complication (40%, n=6/15). About 80.85%, (n=76/94) of patients recovered uneventfully while 19.14% (n=18/94) expired. Conclusion: Peptic ulcer being the common etiology indicates improper peptic ulcer management. Early presentation to the hospital and prompt resuscitation with surgical interventions can improve recovery and reduce mortality in perforative peritonitis.