Acute peritonitis: A clinical study

Abstract

In this study we have tried to find out the incidence of acute peritonitis in relation to age group and sex of the patient and evaluate the relative incidence of various causes of acute peritonitis including trauma. We have also found out the relative incidence of complications and its relation to the primary cause and analyzed the various causes of mortality and morbidity and the factors influencing it. Methods: 50 cases of acute peritonitis due to traumatic and non-traumatic causes admitted in tertiary care center was included in this study. After detailed medical history and clinical examination the patients were taken up for treatment as per the proforma for acute peritonitis. Results: In this series maximum number of cases was seen between the age group of 15-50 years with male patients accounting for 80% of cases. Mean age of patients was 36 years. Pain abdomen (100%), vomiting (56%) and fever (50%) were most common presenting symptoms in all cases of peritonitis. Tenderness and rigidity were present in all the cases. In this series duodenal perforation was the most common cause of acute peritonitis followed by appendicular perforation (16%), ileal (8%), intestinal gangrene (8%), jejunal perforation (6%), gastric perforation (4%) and colonic perforation (2%). All the patients were taken for surgery. Wound infection was must commonest complication (10%) seen in the post-operative period. This was followed by fecal fistula (6%) and pelvic abscess (4%). In general complications septicemia (12%) was the most common. Mortality rate was (12%) in this study with septicemia and multi organ failure being the commonest cause of mortality. Mean age of patients who expired was 51 years. Mortality was clearly more in patients who presented more than 24 hours duration after the onset of symptoms. Conclusion: Duodenal perforation was the most common cause of acute peritonitis, having male predominance. Laparotomy was the treatment of choice.