Epidemiology and Management of Peritonitis at a Rural Hospital in Zambia

Abstract

Background: Peritonitis is a common surgical emergency with varying etiologies encountered the world over. It is associated with significant morbidity and mortality despite intensive research and advances in management.
 Methods: Records of 119 patients operated on for peritonitis at a rural surgical hospital in Zambia over a 10-year period were retrospectively reviewed.
 Results: Common sources of peritonitis were perforated peptic ulcer, acute appendicitis, pelvic inflammatory disease, and perforated terminal ileum. Postoperative period became complicated in 42 patients (32.3%). Fourteen patients (11.8%) died postoperatively; the highest level of mortality was in patients with perforated peptic ulcer (26%). Organ failure was found in 29 patients (24.4%) and was associated with increased risk of death.
 Conclusions: Individual approach with identifying signs of organ failure is essential to determine the patient’s prognosis and decide on the level of care. Patients without organ dysfunction can be successfully managed in a rural surgical hospital.
 Keywords: Peritonitis, Epidemiology, Morbidity, Mortality, Rural hospital, Zambia