A Clinical Study of Management of Perforative Peritonitis and Its Surgical Outcome

Abstract

Background Secondary peritonitis presents common life-threatening conditions associated with high mortality and morbidity. Management of perforative peritonitis poses significant challenges to the treating surgeons with respect to surgical outcome thereby demanding thorough evaluation and appropriate management in such cases. Objectives To study the clinical profile, management of perforative peritonitis and its surgical outcomes. Methodology A case series study of 513 patients with Perforative Peritonitis was studied in setting of tertiary care hospital in the department of general surgery at Vijayanagara Institute of Medical Sciences, Ballari, Karnataka during the period of June 2015 to January 2018. Among the selected patients the clinical profile, etiological profile and the surgical interventions were undertaken and the outcome were noted. Appropriate descriptive statistics were used to analyse the findings and to draw the inferences. Results There were 390 males and 123 females. The mean age of patients was 35.95 ± 24.87 years. Common cause of perforative peritonitis were acid peptic disease (35.7%), infectious disease (23%), trauma (13%) and malignancy (2.3%). Complication rate and mortality among the patients was 47.2% and 9.6% respectively. Elderly age, comorbid condition, infectious disease etiology and malignancy and site of perforation were the important determinants of mortality among the patients. Conclusion GI perforations are one of the most common surgical emergencies. Mortality depends on the age and general condition of the patient, associated pre-operative co-morbidities, site of perforation and etiology.