Perforative Peritonitis—Gastrointestinal Tract May Not Always Be the Source

Desai, Abhay Y.; Palande, Bhakti; Dhabolkar, Sangram; Pai, Vishwas D.

doi:10.1007/s12262-016-1460-7

Cited by 10 publications

(6 citation statements)

References 6 publications

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“…The signs and symptoms are typical and therefore a clinical diagnosis of peritonitis is usually possible. The mainstay of treatment is adequate resuscitation, antibiotics and surgical intervention [5,6] to eliminate the source of bacterial contamination by treating the underlying pathologic process, to decrease the degree of bacterial contamination in the peritoneal cavity and to prevent recurrent or residual infection. This is achieved by either repairing the perforated The commonest site of perforation was peptic perforation accounting for 36.7% of cases, followed by appendicular perforation (23.3%).…”

Section: Introductionmentioning

confidence: 99%

Perforation peritonitis: a clinical profile and management

et al. 2020

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Perforative peritonitis is the most common surgical emergency in general surgical practice[2]. The Indian aetiological spectrum of perforation continues to differ from that of the Western world and there is the paucity of data regarding its aetiology, prognostic indicators, morbidity and mortality pattern. In the majority of cases, delayed presentation to the hospital occurs with well-established generalized peritonitis and varying degree of septicaemia. This descriptive cross-sectional study was conducted at Dr D. Y. Patil Medical College from 2017 to 2019 with a sample size of 30 patients. All details of the patients including clinical history, examination findings, laboratory and radiological investigations, intra-operative findings, and post-operative complications were studied. Perforation peritonitis had a male: female ratio of 3.29:1; and was more commonly seen between the age group of 21-30 years, whereas peptic ulcer perforation had a bimodal distribution (21-30 years and 51-60 years). Appendicular perforation was seen in the younger age group. Small bowel rd perforation commonly occured after 3 decade of life. Descending order of perforation sites: duodenum and stomach, appendix, ileum, jejunum, colon and gall bladder. Commonest aetiology was peptic ulcer perforation, followed by appendicitis and enteric fever. Majority of patients presented after 48 hours, in the stage of established generalised peritonitis. The diagnosis was possible by pneumoperitoneum on X-ray abdomen standing in 70% and only a few needed CT for diagnosis. Laparotomy followed by primary closure of perforation with or without live omental patch was the commonest procedure. Appendicectomy was done in appendicular perforation whereas occasionally, resection anastomosis of involved small bowel segment was required. Proximal diversion was not routinely necessary; only if there are severe contraindications to a primary RA. E. coli was the most common peritoneal contaminating organism followed by Klebsiella and Proteus mirabilis. The post-operative complication rate was 53.3% (wound infection 30%) and the mortality rate was 3.3%.

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Section: Introductionmentioning

confidence: 99%

Perforation peritonitis: a clinical profile and management

et al. 2020

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“…Although uterine perforation is more common in post-menopausal women, the spontaneous rupture of the uterus in the setting of pyometra is still very rare. 5 Ruptured pyometra has a median age of 73.8 years of age and have a 25-40% mortality rate after rupture. 6 As uterus is an intraperitoneal structure, its rupture due to underlying infection and spillage of pus into the abdominal cavity may lead to a surgical emergency.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous uterine perforation presenting as acute abdomen: a diagnostic challenge

Niraj Gupta,

Shelja Rawat,

Nitin Verma

et al. 2023

Int Surg J

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Spontaneous uterine perforation resulting in generalized peritonitis in postmenopausal women is a very rare entity usually caused by pyometra and is associated with high morbidity and mortality. The clinical picture of uterine perforation secondary to pyometra are similar to hollow viscus perforation which makes preoperative diagnosis difficult. Definitive diagnosis can be made with laparotomy or laparoscopy. We report a case of 62 years old female patient who presented with acute generalized peritonitis with pneumoperitoneum having history of pigtail insertion right kidney for right non-functional kidney with gross hydronephrosis two days back, which was more complicating the clinical picture. This case report aims to alert surgeons to the possibility that uterine perforation secondary to pyometra also shows air under diaphragm apart from hollow viscus perforation.

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“…This leads to uterine infections and may culminate in frank perforation. Although more common in post-menopausal women, the spontaneous rupture of the uterus in the setting of pyometra is still very rare [ 4 , 5 ]. Ruptured pyometra has a median age of 73.8 years of age and carries a 25-40% mortality rate following rupture [ 1 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

Generalized Peritonitis Secondary to Perforated Uterine Pyometra

Biller¹,

Winegardner²,

Sleet³

2022

Cureus

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Generalized peritonitis with sepsis is a common general surgery emergency. The most likely implicated structure for generalized peritonitis with pneumoperitoneum is the gastrointestinal tract with urgent explorative laparotomy being the most definitive treatment. In this particular case, perforated diverticulitis was suspected and upon an exploration of the abdomen, frank pus in the setting of normal colon was noted. Some common differential diagnoses for frank pus in the abdomen include viscus perforation, pancreatic necrosis, gangrenous cholecystitis, or penetrating abdominal trauma. Here, we report a rare occurrence of peritonitis secondary to uterine rupture from pyometra.

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Perforative Peritonitis—Gastrointestinal Tract May Not Always Be the Source

Cited by 10 publications

References 6 publications

Perforation peritonitis: a clinical profile and management

Perforation peritonitis: a clinical profile and management

Spontaneous uterine perforation presenting as acute abdomen: a diagnostic challenge

Generalized Peritonitis Secondary to Perforated Uterine Pyometra

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