Spectrum of perforation peritonitis in Kashmir: a prospective study at our tertiary care centre

Ahmad, Muzaffar; Wani, Mumtazudin; Dar, Hanief Mohamed; Thakur, S.; Wani, Hilal Ahmad; Mir, Irfan Nazir

doi:10.18203/2349-2902.isj20150504

Cited by 5 publications

(5 citation statements)

References 9 publications

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“…In developing countries the perforations of proximal gastrointestinal tract are six times more common than distal gastrointestinal tract. [2][3][4] Although exploratory laparotomy is gold standard procedure for perforation peritonitis, but in high risk patients and no improvement in general condition despite all resuscitative measures taken, emergency laparotomy under general anaesthesia is not advisable. 5 Various alternatives to immediate laparotomy recommended are primary peritoneal drainage (PPD), laparoscopic sanitation; Taylor's conservative method.…”

Section: Introductionmentioning

confidence: 99%

Role of peritoneal drainage in moribund patients of perforation peritonitis

Jaiswal

Sharma

2020

Int Surg J

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Background: Objective of the present study was to evaluate applicability of primary peritoneal drainage under local anesthesia in moribund patients as pre-laparotomy support when laparotomy under general anesthesia could not be done. Also to assess outcome in terms of survival, patients needing definitive surgery and complications associated with the procedure on immediate and follow up basis.Methods: We conducted this study in Teerthanker Mahaveer Medical College, Moradabad, UP, India from October 18 to October 2019. 71 patients were admitted as cases of perforation peritonitis in moribund condition, demographic data of all patients was noted, peritoneal drainage under local anesthesia in flanks was done and variable amount of fluid was drained in different patients, simple parameters were taken in to consideration in pre and post drainage phase. We also noted the complications after the definitive surgery.Results: Out of 71 patients, admitted in late and in very critical state, 61 patients improved after drainage and resuscitative procedures, although in ASA grade 3 and 4 they underwent surgical treatment and we were able to save their lives. 13 patients expired after definitive surgery inspite of best efforts.Conclusions: Peritoneal drainage under local anesthesia in late reporting and critical patients, not only improves general condition but makes patients better to undergo further surgery, and can prove to be life saver. It being a simple procedure can easily be done at even PHC level, before patient is referred or shifted to higher centre for further management.

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Section: Introductionmentioning

confidence: 99%

Role of peritoneal drainage in moribund patients of perforation peritonitis

Jaiswal

Sharma

2020

Int Surg J

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“…1,2 In developing countries the perforations of proximal gastrointestinal tract are six times more common than distal gastrointestinal tract. [3][4][5] Although phenomenon of self-healing has been claimed to be efficient in 50% of patients yet a large number of patients require definitive treatment. 6,7 Laparotomy has been the gold standard for the definitive management.…”

Section: Introductionmentioning

confidence: 99%

Primary peritoneal drainage in critically ill patients of perforation peritonitis (an experience of 60 cases)

Bhasin¹,

Sharma²,

Azad³

2017

Int Surg J

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Background: Objective of the present study was to evaluate applicability of Primary Peritoneal Drainage (PPD) under LA in critically ill patients as pre-laparotomy support when laparotomy under GA could not be done. Also to assess outcome in terms of survival, patients needing definitive surgery and complications associated with the procedure on immediate and follow up basis.Methods: A prospective designed study including 60 critically ill patients admitted and diagnosed as perforation peritonitis were subjected to PPD under LA as per inclusion and exclusion criteria, at GMC Jammu, Jammu and Kashmir, India from November 2013 to October 2015.Results: The average age of patients was 53.43 years (20-80 years) with M:F ration of 7:3. All patients presented in shock with very high ASA, combined and MPI scores. 40 patients died after PPD/laparotomy and 20 patients survived. From amongst survivors, 08 (40%) patients required no further treatment and 12 (60%) survivors required definitive laparotomy and treatment of the cause. Overall mortality was 66.67%, attributed to extraordinary delay in presentation, old age, High ASA and other score.Conclusions: From the present study it was concluded that in adults the procedure did not proved comparable to standard surgical intervention as definite procedure but it did proved to be an effective modality of resuscitation and patient stabilization unlike in NEC of infants; PPD under LA. Overall the procedure is a low cost intervention and provide cheaper alternative to sustain and improvise the status of patient with a possibility of widespread applicability in low resource situations provided interdepartmental support from ICU, Dialysis and CCU is available.

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“…Perforations of proximal gastrointestinal tract are more common than distal gastrointestinal tract in developing countries. 2 It has been reported commonly in the younger age group in Asians, with the majority of patients being male 2,3 . Early diagnosis and aggressive management strategy is crucial for the successful treatment of perforation peritonitis.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of Primary Peritoneal Drainage and Taylor’s Conservative Method in High-Risk Cases of Perforated Peritonitis

Suleman¹,

Anwer²,

Naqi³

2023

PJMHS

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Aim: To evaluate the outcomes of primary peritoneal drainage and Taylor’s conservative method in high-risk patients of perforated peritonitis. Methods: The study was carried out within 6 months after the approval of synopsis i.e. from 21st August, 2020 till 20th February, 2021, in the East Surgical department, Mayo hospital Lahore. A total of 66 patients who fulfilled the inclusion criteria were enrolled. Percutaneous peritoneal drainage was performed under local anesthesia and two wide bored intra-abdominal tube drains were placed in both flanks through these incisions. Pus/fluid/bile was evacuated. Outcomes were monitored in terms of mortality, morbidity (SSI, wound dehiscence) and need for definitive surgery after PPD within 14 days (as per operational definition). Post stratification Chi square test was applied and a p-value of ≤0.05 was considered as significant. Results: The mean age of the patients was 49±9.9. Mortality occurred in 65.2% patients, morbidity was seen in 25.8% patients, out of which 13.6% patients had superficial SSI. 62.1% patients had to undergo laparotomy. However, only 31.8% of the patients died postoperatively after definitive laparotomy, which is less than the high mortality rate in high-risk patients of perforation peritonitis. Conclusion: We have concluded from our study that PPD with Taylor’s conservative method served as an effective method of initial resuscitation and stablilization in high-risk patients of perforation peritonitis. Once the general condition of the patients improved, they were subjected to definitive laparotomy under general anesthesia. Post-laparotomy outcomes were improved in such patients. Keywords: peritonitis, drainage, laparotomy

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Spectrum of perforation peritonitis in Kashmir: a prospective study at our tertiary care centre

Cited by 5 publications

References 9 publications

Role of peritoneal drainage in moribund patients of perforation peritonitis

Role of peritoneal drainage in moribund patients of perforation peritonitis

Primary peritoneal drainage in critically ill patients of perforation peritonitis (an experience of 60 cases)

Outcomes of Primary Peritoneal Drainage and Taylor’s Conservative Method in High-Risk Cases of Perforated Peritonitis

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