Perforation Peritonitis:A Two Year Experience.

ABSTRACT

Four hundred patients who presented in the emergency of GMC Jammu as a case of perforation peritonitis over a period of two years were studied. In most of the cases diagnosis was made by clinical examination supplemented by investigations in the form of standing X-ray chest PA view with domes of diaphragm, Ultrasound abdomen and abdominal paracentesis. Contrast enhanced CT scans of abdomen were conducted on patients where the diagnosis of perforation peritonitis was doubtful. After resuscitation, Laparotomy was done in all the patients and thorough peritoneal lavage was done. A note of the site, size, type, number of perforations was made and biopsy was taken from the edge of the perforation whenever indicated. The most common cause of gastrointestinal perforation in our study was duodenal ulcer perforation, followed by appendicitis, typhoid perforation, blunt/penetrating trauma, gastric perforation, obstruction, iatrogenic, malignancy, and recurrent perforation. Primary closure of the perforation was most commonly done procedure, followed by appendectomy, resection anastomosis of the gut and exteriorization of the gut. The overall mortality was 6 % and morbidity in the form of wound infection, fever, respiratory complications, residual abscess, dyselectrolytemia, burst abdomen, jaundice, sepsis, cardiac complications, anastomotic disruption was present