Peritonitis in patients over the age of 50 years: 98 cases managed surgically

Bachkaniwala, Vatsal; Sunder, N.; Saleem, K M; Kilpadi, Arun B

doi:10.1258/004947505774938611

Cited by 6 publications

(4 citation statements)

References 8 publications

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“…Respiratory complications are the known risk factors for the high mortality [32]. Relook laparotomies and intestinal stoma have a definite role to play in perforation peritonitis [33]; as seen in our study, 3.9 % patients went through redo surgery, intestinal stoma, and tension suturing. Factors contributing to redo surgery were persistent septicemia due to abdominal collection, interloop abscess, anastomosis leakage, and burst abdomen.…”

Section: Discussionsupporting

confidence: 58%

Spectrum of Perforation Peritonitis in Delhi: 77 Cases Experience

Yadav

Garg

2012

Indian J Surg

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Perforation peritonitis is the most common surgical emergency encountered by surgeons all over the world as well in India. The spectrum of etiology of perforation peritonitis in tropical countries continues to differ from its western counterpart. This study was conducted at Hindu Rao Hospital, Municipal Corporation of Delhi, New Delhi, India, designed to highlight the spectrum of perforation peritonitis in the eastern countries and to improve its outcome. This prospective study included 77 consecutive patients of perforation peritonitis studied in terms of clinical presentations, causes, site of perforation, surgical treatment, postoperative complications, and mortality at Hindu Rao Hospital, Delhi, from March 1, 2011 to December 1, 2011, over a period of 8 months. All patients were resuscitated and underwent emergency exploratory laparotomy. On laparotomy cause of perforation peritonitis was found and controlled. The most common cause of perforation peritonitis noticed in our series was perforated duodenal ulcer (26.4 %) and ileal typhoid perforation (26.4 %), each followed by small bowel tuberculosis (10.3 %) and stomach perforation (9.2 %), perforation due to acute appendicitis (5 %). The highest number of perforations was seen in ileum (39.1 %), duodenum (26.4 %), stomach (11.5 %), appendix (3.5 %), jejunum (4.6 %), and colon (3.5 %). Overall mortality was 13 %. The spectrum of perforation peritonitis in India continuously differs from western countries. The highest number of perforations was noticed in the upper part of the gastrointestinal tract as compared to the western countries where the perforations seen mostly in the distal part. The most common cause of perforation peritonitis was perforated duodenal ulcer and small bowel typhoid perforation followed by typhoid perforation. Large bowel perforations and malignant perforations were least common in our setup.

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Section: Discussionsupporting

confidence: 58%

Spectrum of Perforation Peritonitis in Delhi: 77 Cases Experience

Yadav

Garg

2012

Indian J Surg

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“…Factors contributing to the high mortality and postoperative complications are advanced age, late presentation, delay in the treatment, septicemia and associated co morbid, Respiratory complications are the known risk factors for the high mortality [ 32 ]. Re look laparotomies and abdominal washout had a definite role to play in perforation peritonitis [ 33 ], as seen in our study 37.3% patients go through redo surgery. Abdominal washout and tension suturing, factors contributing to redo surgery were persistent septicemia due to abdominal collection, inter loop abscess, anastomosis leakage and burst abdomen.…”

Section: Discussionsupporting

confidence: 52%

Spectrum of perforation peritonitis in Pakistan: 300 cases Eastern experience

et al. 2008

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Background: Perforation peritonitis is the most common surgical emergency encountered by the surgeons all over the world as well in Pakistan. The spectrum of etiology of perforation peritonitis in tropical countries continues to differ from its western counter part. This study was conducted at Dow University of health sciences and Civil Hospital Karachi (DUHS & CHK) Pakistan, designed to highlight the spectrum of perforation peritonitis in the East and to improve its outcome.

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“…[19][20][21][22] Acid peptic disease was the second commonest cause of perforation requiring an early surgery for a favourable outcome. We found that in such cases the closure of perforation using a Graham's omental patch was a simple procedure with low mortality as supported by Subramanyam et al [23] Primary intestinal tuberculosis is common in developing countries like India as compared to the western countries. Extrapulmonary tuberculosis most commonly affects the ileocaecal region and the terminal ileum.…”

Section: Discussionsupporting

confidence: 53%

Spectrum of Perforation Peritonitis at a Tertiary Care Centre in Punjab

Gupta¹,

Gill²,

Singla³

et al. 2018

jemds

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BACKGROUND Perforation peritonitis is the most common surgical emergency encountered by the surgeons all over the world. It requires an urgent surgical intervention and is a significant cause of morbidity and mortality. The present study was carried out to analyse the frequency, aetiology and common sites of secondary perforation peritonitis in our setup. MATERIALS AND METHODS This study was conducted as a descriptive study analysing 426 patients of secondary peritonitis from July 2012 till June 2017 at Dayanand Medical College and Hospital, Ludhiana. All cases found to have peritonitis as a result of perforation of any part of gastrointestinal tract at the time of surgery were included in the study. All cases with either primary peritonitis or that due to anastomotic dehiscence were excluded. RESULTS A total of 426 patients were studied, which included 328 males and 98 females. Majority (89%) of the patients were in the third and fourth decades of life. Pain was the commonest presenting symptom. Most common site of perforation was small intestine with 44.3% cases in ileum, 23% in duodenum and 4% in jejunum and the commonest associated risk factor was typhoid (40.3%). Overall, the mortality rate was 20.6%. CONCLUSION Majority of perforation peritonitis cases in the study comprised of typhoid ileal perforations, which leads to the realisation of the impending need to strengthen the hygienic conditions in the area. Overall morbidity and mortality were acceptable. The basic principles of early diagnosis, prompt resuscitation and urgent surgical intervention still form the cornerstones of management in these cases.

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Peritonitis in patients over the age of 50 years: 98 cases managed surgically

Cited by 6 publications

References 8 publications

Spectrum of Perforation Peritonitis in Delhi: 77 Cases Experience

Spectrum of Perforation Peritonitis in Delhi: 77 Cases Experience

Spectrum of perforation peritonitis in Pakistan: 300 cases Eastern experience

Spectrum of Perforation Peritonitis at a Tertiary Care Centre in Punjab

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