ABSTRACT
INTRODUCTION: Perforation peritonitis mostly results from the perforation of a diseased viscus. Other causes of perforation include abdominal trauma, ingestion of sharp foreign body and iatrogenic perforation. The diagnosis is mainly based on clinical grounds. Plain abdominal X-rays (erect) may reveal dilated and oedematous intestines with pneumoperitoneum. Ultrasound and CT scan may diagnose up to 72% and 82% of perforation respectively. The present study was carried out to study various etiological factors, modes of clinical presentation, morbidity and mortality patterns of perforation peritonitis presented in the RIMS hospital, Imphal, India. MATERIAL AND METHODS: The study was conducted from September 2010 to August 2012 on 490 cases of perforation peritonitis admitted and treated in the Department of Surgery. Initial diagnosis was made on the basis of detailed history, clinical examination and presence of pneumoperitoneum on erect abdominal X-ray. RESULTS: A total of 490 patients of perforation peritonitis were included in the study, with mean age of 48.28 years. 54.29% patients were below 50 years and 45.71% patients were above 50 years. There were 54.29% male patients and 45.71% female patients. Only 30% patients presented within 24 hours of onset of symptoms, 31.43% patients presented between 24 to 72 hours and 38.57% patients presented 72 hours after the onset of symptoms. Mean duration of presentation was 54.7 hours. Overall 469 patients were treated surgically and 21 patients were managed conservatively. Overall morbidity and mortality recorded in this study were 52.24% and 10% respectively.
ABSTRACT
Ileosigmoid knot, also known as compound volvulus, is an unusual and a rare cause of intestinal obstruction. We are reporting a case of ileosigmoid knot in a 30-year-old male, who presented with lower abdominal pain. On examination, there was tenderness in the suprapubic area and later, the patient developed features of peritonitis. Exploratory laparotomy revealed a large volume of haemorrhagic fluid with gangrenous sigmoid colon, distended and gangrenous ileum twisted round the base of the sigmoid loop. Gangrenous portion of the ileum and sigmoid colon was resected and end to end anastomosis with Hartmann's procedure was done.
